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Kang JY, Kim D, Kim H, Ha IH, Lee YJ. Health Care Utilization for Common Shoulder Disorders: Analysis of the 2010-2019 National Patient Sample Data from the Health Insurance Review and Assessment Service in Korea. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:744. [PMID: 38792927 PMCID: PMC11122813 DOI: 10.3390/medicina60050744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/23/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024]
Abstract
Background and Objective: The aim of this study was to analyze trends in surgical and non-surgical service utilization for common shoulder disorders in Korea from 2010 to 2019. Methods and Materials: This retrospective, cross-sectional, descriptive study utilized National Patient Sample data from the Health Insurance and Review Assessment Service (HIRA) of Korea. These data constitute a 2% sample out of the entire Korean population and include data for a variety of parameters instrumental for health care research. Patients with at least one medical service use for rotator cuff syndrome or tear, impingement syndrome, or adhesive capsulitis between January 2010 and December 2019 were included. Trends in healthcare utilization by disorder type, patient demographics, seasonal service use, and treatment details were examined. Results: There was an upward trend in the total number of patients and costs for shoulder disorders, from 35,798 patients and USD 5,485,196 in 2010 to 42,558 and USD 11,522,543 in 2019, respectively. The number of patients aged ≥60 and hospital visits increased. March had the highest number of claims. Physical therapy was the most common non-surgical procedure, while nerve block claims more than doubled. Opioid prescription rates also tripled. Surgical treatments were dominated by shoulder rotator cuff repair and acromioplasty. Conclusions: There was a significant increase in healthcare utilization for shoulder disorders, marked by rising costs and patient numbers. The use of nerve blocks and opioids notably increased. These data are valuable for clinicians, researchers, and policymakers.
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Affiliation(s)
- Jin-Young Kang
- Jaseng Hospital of Korean Medicine, Seoul 06110, Republic of Korea;
| | - Doori Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea (I.-H.H.)
| | - Huijun Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea (I.-H.H.)
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea (I.-H.H.)
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul 06110, Republic of Korea (I.-H.H.)
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Alqarni AM, Nuhmani S, Muaidi QI. Glenohumeral internal rotation deficit in volleyball players with and without a history of shoulder pain. Res Sports Med 2024; 32:225-234. [PMID: 35860916 DOI: 10.1080/15438627.2022.2102915] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
This study aimed to investigate physiological and pathological Glenohumeral Internal Rotation Deficit (GIRD) in volleyball players with and without a history of shoulder pain. Volleyball players with a history of shoulder pain (n = 18) and without a history of shoulder pain (n = 18), who were matched in age, weight, height, BMI, years of experience and frequency of practice were recruited for this cross-sectional study. Shoulder internal and external rotation Range of Motion (ROM) was measured for the dominant and non-dominant shoulders of each participant using a digital inclinometer. Measurements of GIRD, External Rotation Gain (ERG), and Total Range of Motion (TROM) were calculated. There were significantly higher degrees of GIRD in the pain group (15.65⁰) than the no-pain group (9.06⁰) (p=0.004) and significantly higher differences in the TROM in the pain group (16.17⁰) than the no-pain group (10.17⁰) (p=0.007). There was no correlation between the level of pain and the presented ROM adaptations. The study showed that for volleyball players, pathological GIRD should be defined at 10-18⁰ degrees of GIRD that are accompanied by differences in the TROM that exceeds 8⁰.
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Affiliation(s)
- Ahmed Mohammed Alqarni
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Qassim Ibrahim Muaidi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Rothermich MA, Fleisig GS, Conte SA, Hart KM, Cain EL, Dugas JR. Short-Term Trends in Elbow Ulnar Collateral Ligament Surgery in Collegiate Baseball Players: An Analysis of 25,587 Player-Years. Orthop J Sports Med 2021; 9:23259671211016846. [PMID: 34377712 PMCID: PMC8330484 DOI: 10.1177/23259671211016846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background Trends over time in the incidence of ulnar collateral ligament (UCL) surgeries in National Collegiate Athletic Association Division I baseball players are currently unknown. Purpose/Hypothesis The purpose of this study was to evaluate the trends in UCL surgeries over 3 years in Division I baseball programs. We hypothesized that surgical injuries would be consistently high over the course of the study. Study Design Descriptive epidemiology study. Methods Athletic trainers from Division I baseball programs were invited to participate in an electronic survey over 3 seasons. A total of 155 baseball programs agreed to participate in 2017, 294 programs participated in 2018, and 296 programs participated in 2019. After each of the 3 collegiate baseball seasons, the athletic trainer from each program entered anonymous, detailed descriptive data and surgical information on injured players into a secured database. Results During the 3 years of this study, 100% of the enrolled programs successfully completed the survey (155/155 in year 1, 294/294 in year 2, and 296/296 in year 3). This registry of 745 completed surveys over 3 years represented 25,587 player-years from Division I collegiate baseball. The percentage of programs with at least 1 UCL surgery during this time was 57% in 2017, 51% in 2018, and 49% in 2019. The majority of these players were pitchers (84% overall from the 3 years). Seniors underwent a significantly lower percentage of the UCL surgeries (8% in 2017, 10% in 2018, and 13% in 2019) than did underclassmen. Surgeries were performed most often in-season and least often during the preseason. A slight majority of players undergoing surgery originated from warm-weather states, but the number of these players was never significantly higher than was the number of players from cold-weather states. Most surgeries performed each year were UCL reconstruction, but the percentage of UCL repair with ligament augmentation increased each year (10% UCL repairs in 2017, 20% in 2018, and 25% in 2019). Conclusion UCL injuries requiring surgery were found to be a major source of morbidity in Division I collegiate baseball, supporting our hypothesis. This study can serve as a baseline for tracking long-term trends in UCL surgeries in collegiate baseball.
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Affiliation(s)
| | - Glenn S Fleisig
- American Sports Medicine Institute, Birmingham, Alabama, USA
| | - Stan A Conte
- Conte Injury Analytics LLC, Scottsdale, Arizona USA
| | - Karen M Hart
- American Sports Medicine Institute, Birmingham, Alabama, USA
| | - E Lyle Cain
- American Sports Medicine Institute, Birmingham, Alabama, USA
| | - Jeffrey R Dugas
- American Sports Medicine Institute, Birmingham, Alabama, USA
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Schilling DT, Elazzazi AM. Shoulder Strength and Closed Kinetic Chain Upper Extremity Stability Test Performance in Division III Collegiate Baseball and Softball Players. Int J Sports Phys Ther 2021; 16:844-853. [PMID: 34123536 PMCID: PMC8168989 DOI: 10.26603/001c.24244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/15/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Shoulder strength measured with a handheld dynamometer (HHD) and the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) are clinical tools that have been used to measure athlete's performance and track their progress. PURPOSE The specific aims of this study were to describe baseball (BB) and softball (SB) players isometric strength measures and their performance on the CKCUEST; examine the relationships between strength and the CKCUEST; compare isometric strength measures of the throwing and non-throwing arms; and compare the strength and the CKCUEST measures between BB and SB players. STUDY DESIGN Observational cohort study. METHODS Participants included 50 DIII BB and 24 DIII SB players. Shoulder strength for the internal and external rotators were measured using a HHD and the CKCUEST was performed. The CKCUEST score and power were calculated. Descriptive statistics and paired t-tests were used to compare throwing and non-throwing shoulder strength. Independent t-test was used to compare BB and SB players shoulder strength and the CKCUEST measures. RESULTS The BB players demonstrated significant strength differences between the throwing and non-throwing shoulders and the internal rotators were significantly stronger than the external rotators (p < 0.05), while the strength ratio of the internal and external rotators was not different between arms (p=0.87). The SB players demonstrated no significant strength differences between the throwing and non-throwing shoulders for the internal and external rotators or the strength ratio of the rotators (p > 0.05). There were no significant differences between the strength of the internal and external rotators of the non-throwing shoulder (p=0.075) or the throwing shoulder (p=0.096). The BB players throwing and non-throwing shoulders produced significantly more internal and external force than the SB players (p < 0.001), however, the internal/external rotators strength ratio were similar (p=0.32, p=0.30). The CKCUEST power had inverse and significant correlations (p=0.006, p=0.003) with SB players internal and external rotators, respectively. The CKCUEST power was significantly different between BB and SB players (p < 0.001). CONCLUSION This study presented shoulder rotator strength and CKCUEST reference values for DIII BB and SB players. BB players demonstrated more strength but overall, less symmetry compared to SB players. CKCUEST power may be considered for the evaluation of athletes. LEVEL OF EVIDENCE Level III.
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Eichinger JK, Goodloe JB, Lin JJ, Greenhouse A, Rao MV, Friedman RJ, Roberts JR. Pitch count adherence and injury assessment of youth baseball in South Carolina. J Orthop 2020; 21:62-68. [PMID: 32123489 DOI: 10.1016/j.jor.2020.01.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 01/31/2020] [Indexed: 10/25/2022] Open
Abstract
Introduction Overuse injury in youth overhead athletes remains a concern. The introduction of pitch count guidelines was designed to limit the number of pitches per game. South Carolina is considered a warm weather climate which has been proven to expose overhead athletes to higher risk for injury. The purpose of this study was to detect baseline rates of arm pain and sequelae (injury, surgery, impact on participation) among southern youth baseball/softball players to better counsel players, parents, coaches and league administration on the prevention of arm injury. Methods A survey was distributed to 14 pediatric practices within the South Carolina Pediatric Practice Research Network. The 2-page survey included 28 closed-ended and descriptive questions that investigated physical and psychosocial responses during and after play. Additional questions were conducted on adherence and understanding of USA Baseball guidelines and pitch counting behavior. Results Two hundred and seventy three surveys were completed by parents of baseball/softball players. The players' average age was 11.6 years, who played on an average of 1.78 teams/leagues for 5.2 months each year. Only 26% of baseball players answered "Sometimes", "Often" or "Always" to their arm hurting. Arm fatigue, older age, parent/coach frustration with play, and months played were statistically significantly associated with arm pain. The survey revealed 58.9% of families were familiar with pitch count guidelines. Discussion Arm pain is relatively prevalent among the South Carolina youth baseball community and worse in older players and experience fatigue. This survey found lower percentage of youth overhead athletes experiencing arm discomfort when compared to prior studies. It is important for warm weather climate athletes to abide by guidelines, as they are more susceptible to arm injury. Increased recognition, education and compliance with pitch count guidelines will help protect these youth athletes from overuse injury. Level of evidence IV, Descriptive Epidemiology Study.
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Affiliation(s)
- Josef K Eichinger
- Medical University of South Carolina, Department of Orthopaedic Surgery and Physical Rehabilitation, Department of Pediatrics, USA
| | - J Brett Goodloe
- Medical University of South Carolina, Department of Orthopaedic Surgery and Physical Rehabilitation, Department of Pediatrics, USA
| | - Jackie J Lin
- Medical University of South Carolina, Department of Orthopaedic Surgery and Physical Rehabilitation, Department of Pediatrics, USA
| | - Alyssa Greenhouse
- Medical University of South Carolina, Department of Orthopaedic Surgery and Physical Rehabilitation, Department of Pediatrics, USA
| | - Meghana V Rao
- Medical University of South Carolina, Department of Orthopaedic Surgery and Physical Rehabilitation, Department of Pediatrics, USA
| | - Richard J Friedman
- Medical University of South Carolina, Department of Orthopaedic Surgery and Physical Rehabilitation, Department of Pediatrics, USA
| | - James R Roberts
- Medical University of South Carolina, Department of Orthopaedic Surgery and Physical Rehabilitation, Department of Pediatrics, USA
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Jayanthi NA, Post EG, Laury TC, Fabricant PD. Health Consequences of Youth Sport Specialization. J Athl Train 2020; 54:1040-1049. [PMID: 31633420 DOI: 10.4085/1062-6050-380-18] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Sport specialization is a training method now commonly used by young athletes who hope to achieve elite-level success. This may be defined as (1) choosing a main sport, (2) quitting all other sports to focus on 1 sport, and (3) year-round training (greater than 8 months per year). A number of sports medicine organizations have published recommendations based on the limited evidence available on this topic. The objective of this article was to perform a narrative review of the currently available evidence and sports medicine organizational recommendations regarding sport specialization and its effects on health to guide athletic trainers and sports medicine providers. To accomplish this goal, we conducted a narrative review of articles and position statements on sport specialization published from 1990 through 2018. Injury, overuse injury, serious overuse injury, and lower extremity injury were likely associated with higher degrees of sport specialization in various populations. Sports medicine organizations in general recommended against sport specialization in young athletes and instead promoted multisport participation for physical and psychological benefits. Few long-term data suggest that sport specialization has negative health-related quality-of-life consequences. Higher degrees of sport specialization likely pose risks of overuse injury; however, the age of specialization at which this risk occurs is not known. Because different populations and sports activities may put children at risk for certain injuries, future researchers should monitor large populations with sport-specific prospective active surveillance.
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Affiliation(s)
- Neeru A Jayanthi
- Emory Sports Medicine Center.,Department of Orthopedics, Department of Family Medicine, Emory University School of Medicine, Atlanta, GA
| | - Eric G Post
- School of Exercise and Nutritional Sciences, San Diego State University, CA
| | | | - Peter D Fabricant
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, and Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY
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Poploski KM, Picha KJ, Winters JD, Royer SD, Heebner NR, Lambert B, Abt JP, Lephart SM. Patterns and Associations of Shoulder Motion, Strength, and Function in MARSOC Personnel Without History of Shoulder Injury. Mil Med 2019; 183:e685-e692. [PMID: 29982689 DOI: 10.1093/milmed/usy088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/11/2018] [Indexed: 11/14/2022] Open
Abstract
Introduction Military personnel are at an increased risk of shoulder injuries due to training and deployment demands, however, there is a lack of information on the tactical athlete's upper extremity profile. Therefore, the purpose of this study was to examine shoulder musculoskeletal characteristics, including range of motion (ROM), strength, and function, and the relationships between these measures in Marine Corps Forces Special Operations Command (MARSOC) personnel without history of shoulder injury. Materials and Methods Participants included 195 full-duty male MARSOC personnel (age: 25.38 ± 2.85 yr; height: 1.79 ± 0.06 m, mass: 82.79 ± 7.88 kg) without history of shoulder injury. Measurements of ROM, strength, and function were obtained bilaterally. Shoulder internal rotation (IR) and external rotation (ER) ROM were summed to calculate total arc of motion (ARC). Shoulder IR and ER strength were assessed using an isokinetic dynamometer. Function was evaluated with an explosive push-up. Results MARSOC personnel present with significantly increased ER ROM, and decreased IR ROM and ARC in their dominant shoulder. They demonstrated greater IR strength and peak force during the explosive push-up on the dominant side but no bilateral differences in average or peak rate were found. Correlation analyses suggest a weak inverse relationship between strength and ARC (r = -0.15 to -0.24). Positive relationships between strength and function were identified except for dominant IR strength and push-up variables. Those with the greatest ARC demonstrated significantly weaker IR and ER strength compared to those with less motion. Conclusions MARSOC personnel demonstrate shoulder ROM and strength symmetry patterns similar to overhead athletes. Increased dominant shoulder strength does appear to translate to a bilateral functional performance, but overall performance may be limited by the weaker nondominant upper extremity. As ARC increases, IR and ER rotation strength decrease. Repetitive, increased loading of the dominant shoulder during functional movements and training may increase risk of chronic, overuse-type injuries, common to the military. Unilateral exercises and movement analysis should be incorporated to encourage proper development of bilateral shoulder strength, which may be particularly important in those with high ranges of ARC.
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Affiliation(s)
- Kathleen M Poploski
- Sports Medicine Research Institute, College of Health Sciences, University of Kentucky, 720 Sports Center Dr. Lexington, KY
| | - Kelsey J Picha
- Sports Medicine Research Institute, College of Health Sciences, University of Kentucky, 720 Sports Center Dr. Lexington, KY
| | - Joshua D Winters
- Sports Medicine Research Institute, College of Health Sciences, University of Kentucky, 720 Sports Center Dr. Lexington, KY
| | - Scott D Royer
- Sports Medicine Research Institute, College of Health Sciences, University of Kentucky, 720 Sports Center Dr. Lexington, KY
| | - Nicholas R Heebner
- Sports Medicine Research Institute, College of Health Sciences, University of Kentucky, 720 Sports Center Dr. Lexington, KY
| | - Brad Lambert
- Health Services Support, United States Marine Corps Forces Special Operations Command, Camp Lejeune, NC
| | - John P Abt
- Sports Medicine Research Institute, College of Health Sciences, University of Kentucky, 720 Sports Center Dr. Lexington, KY
| | - Scott M Lephart
- Sports Medicine Research Institute, College of Health Sciences, University of Kentucky, 720 Sports Center Dr. Lexington, KY
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Donohue BF, Lubitz MG, Kremchek TE. Elbow Ulnar Collateral Ligament Reconstruction Using the Novel Docking Plus Technique in 324 Athletes. SPORTS MEDICINE - OPEN 2019; 5:3. [PMID: 30649654 PMCID: PMC6335231 DOI: 10.1186/s40798-018-0174-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 12/02/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND This retrospective case series examined 324 athletes who received elbow ulnar collateral ligament (UCL) reconstruction by a single surgeon in a private practice over a 9-year period. The novel Docking Plus technique for elbow UCL reconstruction in 324 athletes provided good or excellent Conway score results in 88% of patients. The preponderance of previous studies examining UCL reconstruction outcomes were performed by surgeons at one of only three institutions (Andrews Institute, Hospital for Special Surgery, Kerlan Jobe Orthopedic Clinic). METHODS Patients undergoing UCL reconstruction from November 2005 to December 2014 were identified and contacted with a mailed survey and phone call. These patients were given a subjective 19 question survey assessing their outcomes from surgery. RESULTS The participants who responded to our survey were 90% male and 77% baseball players, 73% of which were pitchers. Of the baseball players who responded, 51.9% were in high school at the time of their surgery, 37% college, 6.5% minor leagues, and 2.2% in Major League Baseball. After surgery, 36% of survey responders returned to a higher level of competition than previously. For example, a high school athlete who had UCL reconstruction and went on to pitch in college. Further, 45% returned to the same level, and 7% returned to a lower level. Subjective "satisfaction," was reported in 92% of responders and 97.2% reported that, "having surgery was a good idea." Symptom onset in the responding athletes was 58.9% sudden, and 41.1% gradual. Overall, 90.9% of respondents returned to play in less than 1.5 years while 6.3% never were able to return. Re-tear occurred in 2.5% of patients, while 8.8% had subjective nerve dysfunction for at least 3 months following surgery. CONCLUSION The Docking Plus technique can produce excellent subjective and objective results in athletes. Further study is warranted to see the effects of this procedure in other settings and determine which method of reconstruction or repair is superior.
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Affiliation(s)
| | - Marc G. Lubitz
- UMass Medical School, 55 Lake Ave N, Worcester, MA 01655 USA
| | - Timothy E. Kremchek
- Beacon Orthopeadics and Sports Medicine, 500 E Business Way, Cincinnati, OH 45241 USA
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Rothermich MA, Conte SA, Aune KT, Fleisig GS, Cain EL, Dugas JR. Incidence of Elbow Ulnar Collateral Ligament Surgery in Collegiate Baseball Players. Orthop J Sports Med 2018; 6:2325967118764657. [PMID: 29687011 PMCID: PMC5900821 DOI: 10.1177/2325967118764657] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Recent reports have highlighted the progressive increase in the incidence of ulnar collateral ligament (UCL) injuries to the elbow in baseball players of all levels. However, knowledge of the incidence and other epidemiological factors regarding UCL injuries, specifically in college baseball players, is currently lacking. Purpose: To evaluate, over a period of 1 year, the incidence of UCL injuries requiring surgery in National Collegiate Athletic Association (NCAA) Division I baseball programs. Study Design: Descriptive epidemiology study. Methods: A total of 155 Division I collegiate baseball programs agreed to participate in the study. Demographics (position, year, background [location of high school]) for all players on these rosters were obtained from public websites. At the conclusion of the 2017 collegiate baseball season, the athletic trainer for each program entered anonymous, detailed information on injured players through an electronic survey into a secured database. Results: All 155 teams enrolled in the study completed the electronic survey. Of the 5295 collegiate baseball players on these rosters, 134 underwent surgery for an injured UCL (2.5% of all eligible athletes), resulting in a team surgery rate of 0.86 per program for 1 year. These 134 players came from 88 teams, thus 56.8% of the study teams underwent at least 1 surgery during the year. The surgery rate was 2.5 per 100 player-seasons for all players and was significantly higher among pitchers (4.4/100 player-seasons) than nonpitchers (0.7/100 player-seasons). The surgery rate was also significantly higher in underclassmen (3.1/100 player-seasons among freshmen and sophomores) than upperclassmen (1.9/100 player-seasons among juniors and seniors) (incidence rate ratio, 1.7; 95% CI, 1.1-2.4). Players from traditionally warm-weather states did not undergo UCL surgery at a significantly different rate from players from traditionally cold-weather states (2.7/100 player-seasons vs 2.1/100 player-seasons, respectively). Nearly half of surgeries (48.5%) were performed during the baseball season. Conclusion: The incidence of UCL surgeries in NCAA Division I collegiate baseball players represents substantial morbidity to this young athletic population. Risk factors for injuries requiring surgery include being a pitcher and an underclassman. Awareness of these factors should be considered in injury prevention programs. Furthermore, this initial study can serve as a foundation for tracking these surgical injuries in future years and then identifying trends over time.
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Affiliation(s)
- Marcus A. Rothermich
- American Sports Medicine Institute, Birmingham, Alabama, USA
- Marcus A. Rothermich, MD, American Sports Medicine Institute, 833 St Vincent’s Drive, Suite 205, Birmingham, AL 35205, USA ()
| | - Stan A. Conte
- Santa Clara University, Santa Clara, California, USA
| | - Kyle T. Aune
- American Sports Medicine Institute, Birmingham, Alabama, USA
| | | | - E. Lyle Cain
- American Sports Medicine Institute, Birmingham, Alabama, USA
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Lubiatowski P, Kaczmarek P, Cisowski P, Breborowicz E, Grygorowicz M, Dzianach M, Krupecki T, Laver L, Romanowski L. Rotational glenohumeral adaptations are associated with shoulder pathology in professional male handball players. Knee Surg Sports Traumatol Arthrosc 2018; 26:67-75. [PMID: 28197695 DOI: 10.1007/s00167-017-4426-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 01/03/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Glenohumeral range of motion adaptations may affect throwing athletes and contribute to shoulder injury. The purpose of this study was to evaluate shoulder rotation deficits among elite professional handball players and its correlation to the presence of shoulder pain and morphological changes. METHODS Eighty-seven elite professional handball players and 41 healthy non-athlete volunteers participated in the study. Evaluations included measurement of range of internal and external rotation, total arch of motion, identification of shoulder pain and ultrasound scan for diagnosis of rotator cuff tears and internal impingement. RESULTS Glenohumeral rotational deficits (>20-25°) were found among 11 players group (13%). The throwing shoulders in the players group showed a decrease in internal rotation and an increase in external rotation with significantly larger ranges among players compared to the non-athlete group. Internal rotation deficit >20° was associated with higher incidence of shoulder pain among players. Both internal rotation deficits (>25°) and total arch of motion deficit (>20°) co-existed with higher incidence of internal impingement. Shoulder pain was common (36/97-41%) and was associated with decreased external rotation and total arch of motion. Internal impingement (found in 13/87-15%) correlated with decreased rotation ranges and a greater deficit in total arch of motion, whereas higher gain in external rotation correlated with a partial rotator cuff tear (found in 12/87-14%). CONCLUSIONS Shoulder pathologies and problems commonly affected the group of handball players. Greater glenohumeral rotational deficits in throwing shoulders of handball players correlate with shoulder pain and internal impingement, while increased external rotation with partial rotator cuff tears. Such deficits affect 13% of the athlete population. Major clinical relevance of the study is to monitor handball players' shoulders both clinically and by proper imaging. Evaluation of range of rotation seems to identify shoulders at risk of the pathology. LEVEL OF EVIDENCE Cross-Sectional study with control group, Level II.
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Affiliation(s)
- Przemyslaw Lubiatowski
- Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, ul. 28 Czerwca 1956r 135, 62-545, Poznań, Poland. .,Rehasport Clinic, ul. Górecka 20, 60-201, Poznań, Poland.
| | | | - Pawel Cisowski
- Rehasport Clinic, ul. Górecka 20, 60-201, Poznań, Poland
| | - Ewa Breborowicz
- Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, ul. 28 Czerwca 1956r 135, 62-545, Poznań, Poland
| | | | | | | | - Lior Laver
- Department of Orthopaediscs, University Hospital Coventry and Warwickshire, Clifford Bridge Rd, Coventry, CV2 2DX, UK
| | - Leszek Romanowski
- Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences in Poznan, ul. 28 Czerwca 1956r 135, 62-545, Poznań, Poland
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Zaremski JL, McClelland J, Vincent HK, Horodyski M. Trends in Sports-Related Elbow Ulnar Collateral Ligament Injuries. Orthop J Sports Med 2017; 5:2325967117731296. [PMID: 29085844 PMCID: PMC5648099 DOI: 10.1177/2325967117731296] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Elbow ulnar collateral ligament (UCL) injuries are common, particularly in adolescent athletes playing overhead sports. While the incidence and outcomes of surgical UCL injuries are well documented, the nonsurgical UCL injury patterns and injury management in this population are not yet known. PURPOSE/HYPOTHESIS The purpose of this study was to retrospectively assess the injury severity and subsequent management of UCL injuries among competitive athletes aged 11 to 22 years. We hypothesized that nonsurgical UCL injuries would occur more frequently in younger athletes compared with older athletes. STUDY DESIGN Descriptive epidemiological study. METHODS Electronic medical records (using International Classification of Diseases, 9th Revision and 10th Revision and Current Procedural Terminology codes) and keyword searches were used to identify all patients with sports-related UCL injuries between January 2000 and April 2016. A total of 136 records were included. Patients were stratified into 3 age brackets (age 11-13 years, n = 17; age 14-16 years, n = 49; age 17-22 years, n = 70). There were no prior elbow surgical interventions. The main outcome measures included the frequency and severity of UCL injuries and injury management (surgical, nonsurgical). Independent variables included age, UCL injuries per year, and sport classification. RESULTS There were 53 surgical and 83 nonsurgical UCL injuries. The number of nonsurgical cases increased 9-fold from 2000-2008 to 2009-2016. The UCL injuries were distributed as follows: 60 sprains, 39 partial tears, 36 ruptures, and 1 rerupture. Moreover, 7% of sprains, 51% of partial tears, and 78% of ruptures underwent UCL reconstruction. Nonsurgical management was most common in the youngest athletes (age 11-13 years, 100.0% of total injuries; age 14-16 years, 71.4% of total injuries; and age 17-22 years, 44.3% of total injuries) (P = .007). UCL injury volume was most commonly associated with javelin (odds ratio, 6.69; 95% CI, 0.72-61.62; P = .07) and baseball (odds ratio, 1.55; 95% CI, 0.69-3.51; P = .32). CONCLUSION Younger athletes sustained less severe UCL injuries more often than older athletes. Participation in javelin and baseball was associated with a greater likelihood of UCL injuries based on our dataset. This is the first study to provide data on the volume of nonsurgical UCL injuries among athletes in various sports.
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Affiliation(s)
- Jason L. Zaremski
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - JoAnna McClelland
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Heather K. Vincent
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - MaryBeth Horodyski
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
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Zaremski JL, Wasser JG, Vincent HK. Mechanisms and Treatments for Shoulder Injuries in Overhead Throwing Athletes. Curr Sports Med Rep 2017; 16:179-188. [DOI: 10.1249/jsr.0000000000000361] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Hellem AR, Hollman JH, Sellon JL, Pourcho A, Strauss J, Smith J. Ultrasound Evaluation of the Lower Trapezius in Adolescent Baseball Pitchers. PM R 2016; 8:510-9. [DOI: 10.1016/j.pmrj.2015.09.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/31/2015] [Accepted: 09/29/2015] [Indexed: 01/18/2023]
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Glenohumeral range of motion (ROM) and isometric strength of professional team handball athletes, part III: changes over the playing season. Arch Orthop Trauma Surg 2015; 135:1691-700. [PMID: 26296802 DOI: 10.1007/s00402-015-2308-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Indexed: 02/09/2023]
Abstract
INTRODUCTION The aim of our study was to investigate the relation of workload on range of motion and isometric strength of team handball athletes' shoulders over a competitive season. MATERIALS AND METHODS 31 Professional male handball athletes underwent clinical shoulder examinations. Athletes were examined subsequently during the complete playing season (week 0, 6, 22 and 40) to determine bilateral isometric shoulder rotational strength and active range of motion (ROM). In addition, relative (intraclass correlation coefficients (ICC) and absolute (standard error of measurement) reliability were calculated. RESULTS Intraobserver reliability was excellent (ICC 0.76-0.98) for isometric strength and flexibility measurements. Internal rotation (IR) and total arc ROM in the throwing shoulder (TS) decreased significantly (p < 0.05) in both sequences (week 22 to week 40, week 0 to week 40). External rotation (ER) ROM and isometric strength in IR and ER did not change significantly. Glenohumeral internal rotation deficit (GIRD) and external rotation gain (ERG) of the TS decreased significantly between week 22 and week 40, but both did not change overall (week 0 to week 40). There was significant influence on IR ROM (week 22 to week 40) and strength in ER (week 0 to week 40) in the non-throwing shoulder. CONCLUSIONS Several characteristics of handball players' shoulders changed significantly from the beginning to the end of a season. More specifically, the repetitive forces accumulated during the competitive season resulted in altered GIRD, ERG and isometric strength of the dominant glenohumeral joint.
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Zaremski JL, Horodyski M, Donlan RM, Brisbane ST, Farmer KW. Does Geographic Location Matter on the Prevalence of Ulnar Collateral Ligament Reconstruction in Collegiate Baseball Pitchers? Orthop J Sports Med 2015; 3:2325967115616582. [PMID: 26740953 PMCID: PMC4687835 DOI: 10.1177/2325967115616582] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: There has been a significant amount of research in the prevention of throwing injuries. However, one area of research that is lacking is geographic location of play. Warm climates may permit year-round play and increased exposure to throwing arm injury risk. Hypotheses: (1) Pitchers from southern institutions would have greater rates of ulnar collateral ligament reconstruction (UCL-R) compared with pitchers from northern institutions. (2) Pitchers originating from high school teams in warm weather states would have a greater risk of undergoing UCL-R while in college. Study Design: Descriptive epidemiological study. Methods: This study was completed by reviewing publicly obtained records of male collegiate baseball players during the 2008 through 2014 seasons. Data were accessed through online search engines, online baseball media guides, and school websites. Results: A total of 5315 player-years and 2575 pitcher-years were identified. Fifty-eight UCL-R cases were found in collegiate pitchers, 40 of which occurred in the Southeastern Conference (SEC) and 18 in the Big Ten. More injuries (36/58) occurred in pitchers who participated in high school baseball in southern states as compared with northern states (22/58), regardless of location of collegiate participation (χ2 = 28.8, P < .05). The injury rate for pitchers who participated in high school baseball in southern states was 25.3 per 1000 player-years versus 19.1 per 1000 player-years in northern states, with a risk ratio of 1.32 (χ2 = 0.89, P = .35). The injury rate for the SEC versus Big Ten pitchers was 13.3 per 1000 player-years versus 7.8 per 1000 player-years, with a risk ratio of 1.71 (χ2 = 1.45, P = .23). Conclusion: There is a greater likelihood of undergoing UCL-R in the SEC compared with the Big Ten. There is also an increased risk for UCL-R for pitchers who played high school baseball in southern states versus northern states, irrespective of collegiate play location. Clinical Relevance: Pitchers originating from high schools in a warm weather climate may be more likely to undergo UCL-R.
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Affiliation(s)
- Jason L Zaremski
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - MaryBeth Horodyski
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Robert M Donlan
- Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA
| | - Sonya Tang Brisbane
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Kevin W Farmer
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
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Lee J, Kim LN, Song H, Kim S, Woo S. The effect of glenohumeral internal rotation deficit on the isokinetic strength, pain, and quality of life in male high school baseball players. Ann Rehabil Med 2015; 39:183-90. [PMID: 25932414 PMCID: PMC4414964 DOI: 10.5535/arm.2015.39.2.183] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/29/2014] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the effects of glenohumeral internal rotation deficit (GIRD) on the isokinetic strength, body pain, and the quality of life in male high school baseball players of Korea. Methods Fifty-six male high school baseball players were divided into either group A (GIRD≥20°, n=12) or group B (GIRD<20°, n=44). The range of motion in the shoulder and the isokinetic strength were measured. Questionnaires were administered regarding the body pain location by using the visual analogue scale, and the quality of life was measured by using the SF-36 Form. Results All subjects had increased external rotation range of motion and decreased internal rotation in the throwing shoulder. The incidence of GIRD (≥20°) was 21.43% in the present study. In the isokinetic strength test, a significantly weaker muscular state at an angular velocity of 180°/s was observed in group A, compared to group B. For the comparison of the pain, the frequency of shoulder pain was higher (33.93%) than other body pain, among the study subjects. Conclusion GIRD is one of the main risk factors of glenohumeral joint damage, and it is correlated with reduced isokinetic strength and quality of life. High school baseball players will need appropriate shoulder rehabilitation programs for the improvement in their quality of life and performance.
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Affiliation(s)
- Jinyoung Lee
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
| | - Li-Na Kim
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
| | | | - Sunghwan Kim
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul, Korea
| | - Seungseok Woo
- Institute of Health and Exercise, Seoul National University, Seoul, Korea
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Fieseler G, Jungermann P, Koke A, Irlenbusch L, Delank KS, Schwesig R. Range of motion and isometric strength of shoulder joints of team handball athletes during the playing season, Part II: changes after midseason. J Shoulder Elbow Surg 2015; 24:391-8. [PMID: 25306493 DOI: 10.1016/j.jse.2014.07.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/13/2014] [Accepted: 07/25/2014] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Our objective was to investigate the influence of workload and consecutive changes on active range of motion and isometric strength of team handball athletes' throwing shoulders (TSs) because the available data are insufficient. METHODS In a longitudinal investigation, 31 professional male handball athletes underwent a clinical shoulder examination. Athletes were examined at the beginning (week 0), at the end (week 6) of the preseasonal training, and at the end of the half-season (week 22) on both shoulders to determine isometric rotational strength (hand held dynamometer) and active range of motion (goniometer). RESULTS This analysis demonstrates the results subsequently from week 6 to week 22 and from week 0 to week 22. The glenohumeral internal rotation (IR) deficit (GIRD), external rotation (ER) gain, and ER at the TS increased significantly (P < .05, η(2) > 0.10, d > 0.30) in the first sequence (week 6 to week 22) but not significantly from week 0 to week 22. The total range of motion remained stable, and IR changed but not significantly. There was no influence on IR, ER, and total range of motion at the non-TS. The isometric strength of the TS and non-TS IR did not change. The isometric strength in ER significantly increased bilaterally during the investigation period. CONCLUSIONS Our data verify changes and influences, such as an increasing GIRD, at the overhead TS joint in accordance with the workload during team handball season. ER gain did improve after the half-season period but did not fully compensate the GIRD at the TS.
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Affiliation(s)
| | - Philipp Jungermann
- Center for Orthopedic Surgery, Hann. Münden, Germany; Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Alexander Koke
- Center for Orthopedic Surgery, Hann. Münden, Germany; Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Lars Irlenbusch
- Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Karl-Stefan Delank
- Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Rene Schwesig
- Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Moore SD, Uhl TL, Kibler WB. Improvements in shoulder endurance following a baseball-specific strengthening program in high school baseball players. Sports Health 2014; 5:233-8. [PMID: 24427394 PMCID: PMC3658410 DOI: 10.1177/1941738113477604] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: The posterior shoulder muscles play key roles in maintaining shoulder function in throwing. Arm fatigue has been identified as a risk factor for shoulder and elbow pain in youth baseball pitchers. However, endurance of the posterior shoulder muscles in overhead athletes is not routinely examined or conditioned. Hypothesis: Upper extremity muscular endurance can be improved in adolescent baseball players during a 20-week preseason training program. Secondarily, strength will be improved. Finally, these improvements will be associated with maintenance of range of motion. Study Design: Cohort study. Methods: Fourteen baseball players (age, 16 ± 2 years) attended 3 supervised training sessions per week for 20 weeks. Strengthening of the upper extremity was performed with a specific progression that utilized readily available equipment. Testing was completed at baseline and at 4, 8, and 20 weeks. The posterior shoulder endurance test was performed to assess muscular endurance. Glenohumeral internal and external rotation range of motion and strength were measured. Results: Posterior shoulder endurance improved from 30 ± 14 repetitions at baseline to 66 ± 26 at 4 weeks and 88 ± 36 at 20 weeks (P < 0.05). Glenohumeral internal rotation range of motion and the glenohumeral internal/external rotation strength ratio remained similar over the course of the program. Conclusion: Implementation of a preseason training program effectively increased shoulder muscular endurance while maintaining strength ratios and range of motion throughout the 20-week program. Clinical Relevance: This program improved a key parameter known to be associated with shoulder function and injury risk. This study describes a simple clinical tool to assess muscular endurance of the posterior shoulder.
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Affiliation(s)
| | - Tim L Uhl
- University of Kentucky, Lexington, Kentucky
| | - W Ben Kibler
- Shoulder Center of Kentucky, Lexington, Kentucky
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McDonough A, Funk L. Can glenohumeral joint isokinetic strength and range of movement predict injury in professional rugby league. Phys Ther Sport 2013; 15:91-6. [PMID: 23948328 DOI: 10.1016/j.ptsp.2013.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 06/24/2013] [Accepted: 07/04/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To isokinetically record shoulder strength scores and range of motion in a professional rugby league squad. To prospectively monitor injuries over a season looking for associations between measured variables and injury. DESIGN A cohort study design involving prospective screening of risk factors with subsequent injury surveillance. SETTING University Sports Science Laboratory and Professional Rugby League Club. PARTICIPANTS All players participating in the clubs reserve team squad for the 2011 season (n = 20). MAIN OUTCOME MEASURES Concentric (Con) and eccentric (Ecc) peak torque values; ratio of Ecc internal rotation IR to Con external rotation ER, also known as the dynamic control ratio (DCR), shoulder range of IR and ER. RESULTS Eight players (36%) received a total of eleven injuries over the season. There were no statistically significant differences between injured and non-injured shoulders. IR range of movement was significantly lower in injured versus non-injured groups with left (p = 0.022) and right (p = 0.024). Left IR range of movement was predictive of injury using binary logistic regression (p = 0.046). No isokinetic strength parameters reached statistical significance (p > 0.05) for prediction of injury; however size effects were apparent for reduced con IR of the left shoulder and Ecc IR of both shoulders. CONCLUSION Reduced shoulder IR range appears predictive of future shoulder injury although caution is drawn due to small participant numbers. Injury prevention strategies for rugby league players should include exercises to improve shoulder IR and possibly Ecc IR strength.
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Affiliation(s)
- Andrew McDonough
- 3 Olivedale Road, Liverpool L18 1DD, UK; The University of Bath, Claverton Down, Bath BA2 7AY, UK.
| | - Lennard Funk
- Upper Limb Unit, Wrightington Hospital, Hall Lane, Appley Bridge, WN6 9EP, UK
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Almeida GPL, Silveira PF, Rosseto NP, Barbosa G, Ejnisman B, Cohen M. Glenohumeral range of motion in handball players with and without throwing-related shoulder pain. J Shoulder Elbow Surg 2013. [PMID: 23177170 DOI: 10.1016/j.jse.2012.08.027] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Overhead athletes are subject to adaptations in the shoulder including glenohumeral internal rotation deficit (GIRD). It has been documented that this alteration is more evident in overhead athletes with pain. Our objective was to compare glenohumeral rotation motion between symptomatic and asymptomatic handball players. MATERIALS AND METHODS Glenohumeral rotation range of motion, GIRD, external rotation gain (ERG), and total rotation motion were determined with a standard goniometer in 30 handball players with pain and 27 without pain. Differences between the throwing and non-throwing shoulder were determined in each group. RESULTS Handball players with pain had significantly greater GIRD (P = .002), ERG (P = .027), and external rotation in the throwing arm (P = .042) and lesser internal rotation in the throwing arm (P = .029) in comparison to the athletes without pain. Comparisons between limbs exhibited a significant difference in the 2 groups regarding internal and external rotation (P < .02), but differences within the group with pain were greater. Differences were not found in the total rotation motion between the 2 groups. CONCLUSION Handball players showed specific adaptations in the throwing shoulder; in particular, handball players with pain have greater GIRD, ERG, and external rotation and lesser internal rotation of the throwing shoulder.
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Affiliation(s)
- Gabriel Peixoto Leão Almeida
- Sports Traumatology Center, Orthopaedic and Traumatology Department, Federal University of São Paulo, São Paulo, Brazil.
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Kordi H, Mohamadi J, Ghotbi M. Teaching of new sport skill to weightlifters: problem in performance and motor learning. JOURNAL OF HUMAN SPORT AND EXERCISE 2013. [DOI: 10.4100/jhse.2013.84.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Longo UG, Loppini M, Berton A, Martinelli N, Maffulli N, Denaro V. Shoulder injuries in soccer players. CLINICAL CASES IN MINERAL AND BONE METABOLISM : THE OFFICIAL JOURNAL OF THE ITALIAN SOCIETY OF OSTEOPOROSIS, MINERAL METABOLISM, AND SKELETAL DISEASES 2012; 9:138-141. [PMID: 23289025 PMCID: PMC3536009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Even though soccer is the most popular sport of the world, no review is available at present to resume the available data on shoulder injuries in soccer. The aim of this review is to report the available epidemiological data on shoulder specific injuries in soccer players and to describe the common mechanisms of shoulder injuries in soccer. Studies published through September 15, 2011, were identified by using MEDLINE, EMBASE, CINAHL and Pre-CINAHL, Pub-Med, Web of Science, and the full Cochrane Library. Reference lists of included studies were searched by hand. Studies were included if they reported on shoulder injuries in soccer players. Limits were not placed on year of publication, status of publication, or language. The journal, authors, and author affiliations of included studies were masked from 2 reviewers. We planned to perform a study on the epidemiology, mechanisms and management of shoulder injuries in elite soccer players. We also planned to use Review Manager (RevMan. Version 5 for Windows) to calculate the magnitude of treatment effect. No studies on clinical outcome of shoulder injuries in elite soccer athletes were found. No studies on the mechanism of shoulder injury in elite soccer players were found. The results of the available studies on epidemiology are reported. Despite soccer is the world's game, few studies focused on shoulder injuries in soccer players, and therefore no definitive conclusions can be drawn. Further research is warranted to clarify the epidemiology, mechanisms and management of shoulder injuries in elite soccer players.
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Affiliation(s)
- Umile Giuseppe Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria Rome, Italy
| | - Mattia Loppini
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria Rome, Italy
| | - Alessandra Berton
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria Rome, Italy
| | - Nicolò Martinelli
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria Rome, Italy
| | - Nicola Maffulli
- Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, England
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Trigoria Rome, Italy
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Abstract
CONTEXT Although baseball is a relatively safe sport, numerous reports suggest a rapid rise in elbow injury rate among youth baseball pitchers. EVIDENCE ACQUISITION PUBMED WAS SEARCHED FOR EPIDEMIOLOGIC, BIOMECHANICAL, AND CLINICAL STUDIES OF ELBOW INJURIES IN BASEBALL (KEYWORDS: "youth OR adolescent" AND baseball AND pitching AND "ulnar collateral ligament OR elbow"; published January 2000 - April 2012). Studies with relevance to youth baseball pitchers were reviewed. Relevant references from these articles were also retrieved and reviewed. Original data, insight, and recommendations were added. RESULTS The majority of baseball elbow injuries are noncontact injuries to the dominant arm resulting from repetitive pitching. Five percent of youth pitchers suffer a serious elbow or shoulder injury (requiring surgery or retirement from baseball) within 10 years. The risk factor with the strongest correlation to injury is amount of pitching. Specifically, increased pitches per game, innings pitched per season, and months pitched per year are all associated with increased risk of elbow injury. Pitching while fatigued and pitching for concurrent teams are also associated with increased risk. Pitchers who also play catcher have an increased injury risk, perhaps due to the quantity of throws playing catcher adds to the athlete's arm. Another risk factor is poor pitching biomechanics. Improper biomechanics may increase the torque and force produced about the elbow during each pitch. Although throwing breaking pitches at a young age has been suggested as a risk factor, existing clinical, epidemiologic, and biomechanical data do not support this claim. CONCLUSIONS Some elbow injuries to youth baseball pitchers can be prevented with safety rules, recommendations, education, and common sense. Scientific and medical organizations have published safety rules and recommendations, with emphasis on prevention of overuse and pitching while fatigued. STRENGTH-OF-RECOMMENDATION TAXONOMY (SORT): A.
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Cohn RM, Jazrawi LM. The Throwing Shoulder: the Orthopedist Perspective. Magn Reson Imaging Clin N Am 2012; 20:261-75, x. [DOI: 10.1016/j.mric.2012.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Adaptations at the Shoulder of the Throwing Athlete and Implications for the Clinician. TECHNIQUES IN SHOULDER AND ELBOW SURGERY 2012. [DOI: 10.1097/bte.0b013e31823fe84f] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bibliography Current World Literature. CURRENT ORTHOPAEDIC PRACTICE 2012. [DOI: 10.1097/bco.0b013e3182434f58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Reider B. National pastime. Am J Sports Med 2011; 39:249-51. [PMID: 21300813 DOI: 10.1177/0363546511398215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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