Injury Profile of Male and Female Senior and Youth Handball Players: A Systematic Review

The HAPPY concept mapping study: "To prevent injuries in young handball players it's important to…" - Perceptions among stakeholders

OBJECTIVES

This study aimed to identify facilitators for implementing injury prevention initiatives in youth handball, and to assess stakeholders' perceptions of their importance and feasibility.

DESIGN

Mixed-method concept mapping study.

METHODS

Four stakeholder groups - coaches, administrators, health staff and players - participated in this mixed-method concept mapping study. Participants (n = 224; 19 % coaches, 22 % health staff, 63 % players, 18 % administrators) first provided statements about facilitators for implementing injury prevention initiatives in youth handball, then thematically grouped them (n = 47), before rating them (n = 57) for importance and feasibility (5-point Likert scales). Stakeholder-specific cluster maps and Go-Zone scatter plots were created. Statements rated above average for both importance and feasibility were considered as prioritized (Go-Zone 1).

RESULTS

87 unique statements were generated during brainstorming. Multidimensional scaling and hierarchical cluster analysis resulted in similar sorting data clustering patterns for coaches, health staff, and administrators, which included federation strategies, club strategies, and coach and athlete education/knowledge. All clusters were rated >3 on average ratings of importance by all stakeholder groups. Six statements were in Go-Zone 1 for all stakeholder groups, including three statements about coach knowledge and education. Players' importance and feasibility ratings had limited overlap with other stakeholder groups' Go-Zone 1 statements. Players' Go-Zone 1 statements mainly addressed individual load management and practical training setup.

CONCLUSIONS

Coach knowledge and education, alongside collaboration among stakeholder groups, are essential when implementing injury prevention initiatives in youth handball. Stakeholder groups have varying perspectives, underscoring the importance of understanding and addressing these diverse viewpoints when implementing injury prevention initiatives in youth handball.

Can tests of physical fitness predict traumatic knee injury in youth female athletes? A prospective cohort study

OBJECTIVES

To compile a battery of test including various aspects of physical fitness that could be used on the field and to assess whether any of these tests are associated with future traumatic knee injuries in youth female team sports athletes.

DESIGN

Prospective cohort.

SETTING

Sport setting.

PARTICIPANTS

Female athletes (n = 117, age 15-19 years), from Swedish sport high schools, active in soccer, handball, or floorball.

MAIN OUTCOME MEASURES

Differences in pre-injury tests values of 11 physical fitness tests in injured versus non-injured athletes, assessed as number of traumatic knee injuries over one season.

RESULTS

28 athletes sustained 34 traumatic knee injuries. Athletes who sustained an injury had a shorter distance on the Yo-Yo IR1 test at baseline than those without an injury (mean difference -193 m, CI -293- -65 m). None of the other tests, assessed for muscular strength, endurance, power, flexibility and dynamic knee valgus, differed between injured and non-injured athletes.

CONCLUSIONS

Youth female athletes with lower intermittent endurance capacity, assessed with the Yo-Yo IR1, seemed to be at greater risk of traumatic knee injury. Neither hop performance, flexibility, dynamic knee valgus nor isolated strength tests at baseline could distinguish between injured and non-injured youth female athletes at follow-up.

Injury Profile in Youth Female Athletes: A Systematic Review and Meta-Analysis

BACKGROUND

An increasing number of epidemiological studies assessing the incidence, prevalence and severity of injury in youth female sport are available. However, no study has sought to synthesise the current evidence base across all youth female sport. As such, a systematic review and meta-analysis of injury in this cohort is necessary to understand the diversity of injury and its associated burden between sports in addition to identifying the density of research available.

OBJECTIVE

To conduct a systematic review and meta-analysis of epidemiological data of injuries in youth female athletes with particular attention to injury incidence, mean days lost and injury burden.

METHODS

Searches were performed in PubMed, EBSCO (SPORTDiscus with Full Text MEDLINE, APA PsycINFO, CINAHL, Academic Search Complete) and Cochrane databases. Studies were considered if they reported time-loss injury incidence or prevalence in youth female (≤ 19 years old) athletes. Study quality and risk of bias were assessed using STROBE-SIIS extension, Newcastle-Ottawa Scale, and funnel plots, respectively. Injury incidence and burden rate data were modelled using a mixed-effect Poisson regression model. Days lost data were modelled using a generalised linear mixed model.

RESULTS

Thirty-two studies were included. The overall incidence rate, mean days lost per injury, and burden rate were 4.4 injuries per 1000 h (95% CI 3.3-5.9), 10 days (95% CI 6-15), and 46 days per 1000 h (95% CI 23-92), respectively. Forty percent of athletes sustained at least one time-loss injury. Competitive level was a significant moderator of match and training injury incidence, with elite youth athletes presenting greater pooled injury incidence estimates than non-elite athletes (p = 0.0315 and p = 0.0047, respectively). The influence of moderators on days lost and injury burden could not be determined due to an insufficient number of studies for analysis.

CONCLUSION

Despite a broad inclusion criterion, there is limited injury surveillance research available across youth female sport. Outside of soccer, little research density is evidenced with single studies available in popular team sports such as Australian football and rugby union. Insufficient study numbers reporting mean days lost and injury burden data were available for analysis, and pooled days lost data could only be estimated for soccer. This highlights a need for future research to report days lost data alongside injury number and exposure so burden can be calculated and the full risk of injury to youth female athletes can be identified.

Ligament Injuries in Professional Male Handball Players: A 6-Year Longitudinal Study

Handball is a sport that involves high-intensity actions throughout the game, such as sprints, jumps, landings, and high-speed, repeated throws. This, along with competitive and tactical factors, congested schedules, and the need to maintain a high level of performance throughout the season, contributes to a high injury rate. This study aimed to analyse ligament injuries in a professional handball team over six consecutive seasons. A total of 68 elite male Spanish handball players participated, with 54 time-loss injuries (i.e., injuries involving at least one day of absence) observed during this study period. Ligament injury information was recorded following the International Olympic Committee consensus statement. The overall incidence was 0.89 ligament injuries per 1000 h of exposure. Additionally, a higher incidence and burden of ligament injuries was observed during match-play compared to training. Most ligament injuries were classified as minor or moderate (i.e., 79.63% of the total), and 46.29% were reinjuries. A significantly higher incidence of ligament injuries was suffered in the lower limbs compared to the upper limbs (0.81 vs. 0.08 ligament injuries per 1000 h; p < 0.001). Specifically, the highest incidence was observed in the anterior talofibular ligament of the ankle (0.57 injuries per 1000 h of exposure), while the greatest burden was related to the anterior cruciate ligament (24.08 absence days per 1000 h of exposure). This study provides an overview of ligament injuries among professional handball players, highlighting the need to implement strategies with positive effects during competition (e.g., specific activation strategies or training programmes based on strength and balance) and to reduce injury recurrences.

Comprehensive evaluation of efficiency to identify deficiencies in muscle activity in different modes in team sports

OBJECTIVE

Aim: To concern the scientific substantiation of a complex ergometer tests of aerobic and anaerobic character and quantitative criteria for assessing the condition of female handball players` respiratory and power supply systems in the maximum.

PATIENTS AND METHODS

Materials and Methods: Descriptive analysis, correlation analysis, factor analysis. In order to solve those tasks within the framework there were measured the indicators of two hundred young female handball players at the pre-basic training stage.

RESULTS

Results: The outcomes of the research allow us to recommend the program for handball players` potential capabilities assessment that will help to characterize the state of power supply systems of the body under aerobic and anaerobic conditions. At the same time, the results of the testing can be used to identify strengths and weaknesses in the structure of handball players` special readiness indicators and to individualize the process of players' preparation at the subsequent stages.

CONCLUSION

Conclusions: As a result of experimental data, the quantitative criteria and the scale for the assessment of handball players' working capacity in ergometer maximum tests of aerobic-anaerobic character have been developed. On the basis of these tests, it is possible to analyze objectively the individual characteristics of children before making a final decision.

Monitoring Training Load and Wellness of Female Footballers Transitioning Between Club and National Teams

ABSTRACT

Brown, GA, Massard, T, Wignell, T, McCall, A, and Duffield, R. Monitoring training load and wellness of female footballers transitioning between club and national teams. J Strength Cond Res 37(11): 2235-2240, 2023-This study described the change in training and match internal loads, plus perceptual wellness during the transition between club and national teams (NTs) for female international footballers (soccer). Session count, session rating of perceived exertion (s-RPE), and perceptual wellness data were collected from 42 players from 1 NT between 2019 and 2021 for 7 NT tournaments. Data were collated into 7-day (1 week) microcycles to compare the 2 weeks before the first week of NT (transition in: NT-2, NT-1, NT1); and separately from the final NT week to the next 2 weeks in clubs (transition out: NTFinal, NT+1, NT+2). Data were analyzed using linear mixed-models, with session count, s-RPE or wellness as the outcome variable, week as the fixed effect, player name, and tournament as random effects. Tukey's adjusted post-hoc comparisons and Cohen's d effect sizes (ES) were compared between weeks. Significance level was set at p < 0.05. During the transition into NT, training and total session counts increased (p < 0.0001, ES > 0.67), training s-RPE increased (p = 0.012, ES = 0.35), whereas match count and s-RPE decreased (p < 0.05, ES < -0.34). During the transition out of NT, there were decreases in training session count (p < 0.05, ES < -0.37), match count, and total session count (p < 0.0001, ES < -0.86), and match and total s-RPE (p < 0.0001, ES < -0.63). Perceived wellness was not significantly different throughout (p > 0.05, ES = -0.34 to 0.35). Thus, training and match exposures differ between club and NTs, demonstrating these unique transitional periods require simple and effective load monitoring to inform training and recovery prescription when changing between club and NTs.

The effect of three different pre-match warm-up structures on male professional soccer players' physical fitness

BACKGROUND

Optimizing the soccer players' match preparation is one of the most relevant concerns of coaches for strength and conditioning training. Thus, the aim of this study was to analyze the effects of three pre-match warm-up structures on the physical condition of male professional soccer players.

MATERIALS & METHODS

Seventeen male professional soccer players (age: 20.9 ± 2.4 years) of one Tunisian Professional Soccer League team participated in this study. Players performed three times a typical pre-match warm-up (WU) [aerobic phase (AE); neuromuscular phase (NM); velocity phase (VL); and ball-specific phase (BS) variating the order of the included phases/exercises: WU1 (AE + BS + NM + VL); WU2 (AE + NM + VL + BS); and WU3 (AE + VL + BS + NM). After each warm-up phase, players completed the following physical fitness tests: linear sprint test, countermovement jump test, 15-m ball dribbling agility test and ball shooting test. Additionally, the rate of perceived exertion (RPE) was registered after each warm-up.

RESULTS

The results indicated significant differences between WU1 and WU3, with better results in the ball shooting test and RPE in WU3. In addition, there were no significant differences in the other variables and between other warm-up structures. These findings could be of great interest for coaches to the strength and conditioning coaches for professional soccer teams in order to improve the players physical performance and perceived exertion.

The effect of progressive and individualised sport-specific training on the prevalence of injury in football and handball student athletes: a randomised controlled trial

Objective

To evaluate the effectiveness of communication and coordination combined with designing a progressive and individualised sport-specific training program for reducing injury prevalence in youth female and male football and handball players transitioning to a sports academy high school. An additional aim was to investigate the characteristics of the reported injuries.

Methods

Forty-two Norwegian athletes were randomised into an intervention or control group. Mean age, height, weight and BMI was 15.5 ± 0.5 years, 178.6 cm ± 6.3 cm, 71.3 ± 9.8 kg, 22.3 ± 2.7 BMI for the intervention group (IG) (n = 23), and 15.4 ± 0.5 years, 175.6 cm ± 6.6 cm, 67.1 ± 9.8 kg, 21.7 ± 2.4 BMI for the control group (CG) (n = 19). During the summer holiday, the intervention group received weekly progressive, individualised sport-specific training programs and weekly follow-up telephone calls from the researchers. All athletes completed a baseline questionnaire and a physical test battery. Training data and injuries were recorded prospectively for 22 weeks using the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2). A two-way chi-square (χ²) test of independence was conducted to examine the relationship between groups and injury.

Results

Average weekly prevalence of all injuries was 11% (95% CI: 8%-14%) in IG and 19% (95% CI: 13%-26%) in CG. Average weekly prevalence of substantial injuries was 7% (95% CI: 3%-10%) in IG and 10% (95% CI: 6%-13%) in CG. The between-group difference in injuries was significant: χ² (1, N = 375) = 4.865, p = .031, φ = .114, with 1.8 times higher injury risk in CG vs. IG during the first 12 weeks after enrolment.

Conclusions

For student athletes transitioning to a sports academy high school, progressive individualised, sport-specific training programs reduced the prevalence of all-complaint injuries following enrolment. Clubs and schools should prioritise time and resources to implement similar interventions in periods where student athletes have less supervision, such as the summer holidays, to facilitate an optimal transition to a sports academy high school.

Associations between upper quarter Y-balance test performance and sport-related injuries in adolescent handball players

Handball players are at a high risk of suffering a sport-related injury. Recent studies in various adult populations (e.g., US Army soldiers/warrior athletes, and military members) showed that poor scores in the upper quarter Y-balance test (YBT-UQ) are related to an increased risk of injury. Yet, it is unclear whether this also applies to adolescent handball players. Thus, the present study aims to determine if pre-season YBT-UQ performance is associated with sport-related injuries during the competitive season in adolescent handball players. One hundred and thirty-three adolescent handball players (age: 15.4 ± 1.7 years; m = 99, f = 42) who competed in the second highest league in the Rhine-Ruhr region, Germany, during the 2021/2022 season participated in the study. Before the competitive season, the players performed the YBT-UQ to assess upper extremity mobility and stability of the throwing and non-throwing arm. Over the 8-month competitive season, the coaches monitored the occurrence of sports-related injuries once a week, using an injury report form from the legal accident insurance. Fifty-seven players (43%) incurred a sport-related injury during the competitive season, of which 27 (47%) had upper body injuries, and 30 (53%) were lower body injuries. The YBT-UQ performance of the throwing and non-throwing arm did not significantly differ between injured and non-injured players. Further, Cox proportional hazard survival regression model analyses revealed that only the presence of an inferolateral reach asymmetry score ≥7.75% arm length was associated with a moderate increase in the risk (hazard ratio = 2.18, 95% confidence interval = 1.02–4.68, p = 0.045) of lower but not upper or whole-body injuries. Our findings suggest that the YBT-UQ has limited value as a field-based screening tool to assess the risk of sport-related injuries in adolescent handball players.

Risk factors for shoulder injuries in handball: systematic review

BACKGROUND

Handball is a sport with a high number of severe injuries. The shoulder is one of the most commonly injured joints, with an average prevalence of 17-41%.

OBJECTIVE

The primary aim is to identify the most significant risk factors related to shoulder injuries in handball. The secondary aim is to propose recommendations based on the available evidence concerning potential injury prevention strategies.

METHODS

Systematic searches of PubMed, MEDLINE, CINAHL, Proquest, SPORTDiscus, Web of Science, EMBASE, and Scopus were undertaken for peer reviewed articles published between 15 July 1995 and 15 July 2019. The same search strategy was repeated on 24 April 2022. Prospective cohort studies, written in English and published in a journal with a peer-review process aiming to investigate at least one modifiable or/and a non-modifiable potential risk factor for shoulder injuries, specifically in handball players, were included. Only papers published after 1995 were included. The methodological quality of the eligible studies was assessed using the modified version of the Downs and Black Checklist. The Best Evidence Synthesis (BES) approach was used for synthesizing and reporting the results.

RESULTS

1849 studies were identified, of which 8 were included. A total of 2536 (males = 1354, females = 1182) participants of which 2522 were handball athletes, were included. Four of the eight studies were rated as high methodological quality studies (> 85%) while the rest were rated as medium (50-85%). The risk factors for shoulder injuries in handball identified in the studies were strength imbalances (n = 6), glenohumeral range of motion (ROM) imbalances (n = 5), scapular dyskinesis (n = 5), incorrect dosage of training load (n = 2), previous injury (n = 1), sex (n = 2), player's position, school grade, playing level (n = 1), altered shoulder joint position sense (n = 1).

CONCLUSION

Overall, from all the risk factors evaluated, there was strong evidence that the weakness of the shoulder external rotator muscles and the female sex increase the probability of shoulder injury in handball athletes. Nevertheless, the evidence for the other risk factors was moderate due to the methodological quality and the limited number of studies.

PROTOCOL REGISTRATION

PROSPERO ID: CRD42020138233.

The Most Common Handball Injuries: A Systematic Review

Handball is a team sport involving a great physical demand from its practitioners in which a high number of injuries occur, affecting individual and collective performance. Knowledge of the injuries is of great importance for their prevention. The objective of the present study was to identify, locate and compare the most frequent injuries and injury mechanisms in handball practice. It was carried out following the Preferred Informed Item for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The source of data collection was direct consultation of the PubMed and Medline databases. Several keywords were used for the documentary retrieval, and the quality of the studies that were selected was evaluated. Of the 707 studies retrieved, only 27 were considered appropriate for the review, and quality scores were obtained that ranged from 10 to 26 points, out of a maximum of 28. The most frequent injuries in handball players are located in the lower limbs (thigh, knee and ankle), and in the shoulder in the upper limbs. Regarding the playing position, the players who play over the 6-m line are the most affected by injuries, while the women players have a higher probability of injury. Most injuries occur during competition.

The Influence of Maturity Status on Dynamic Balance Following 6 Weeks of Eccentric Hamstring Training in Youth Male Handball Players

Information about when to apply an appropriate eccentric hamstring strength training stimulus during long-term athlete development is essential for effective programming and improving balance performance. This study examined the effects of six-week eccentric hamstring training on dynamic balance performance in youth handball players of different maturity statuses (pre- or post-peak height velocity (PHV)). A randomized controlled design with 45 young male handball players (14.6 ± 0.3 years) from a local national handball club were randomly allocated to a 6 week, twice weekly eccentric hamstring training in two experimental groups: a pre-PHV (maturation offset: −2.13 ± 0.63, n = 10) and post-PHV (maturation offset: 0.79 ± 0.34, n = 12) group and two control groups: maturation offset: −2.09 ± 0.61, n = 10 and maturation offset: 0.55 ± 0.67, n = 13. Dynamic balance performance was evaluated by using the composite score during the lower quarter Y-balance test from pre- and post-intervention. A significant effect on balance scores was found from pre to post (F = 11.4; p = 0.002; η2p = 0.22), intervention (F = 5.4; p = 0.025; η2p = 0.12), and maturation (F = 369; p < 0.001; η2p = 0.9), but no significant interaction effects were found (F ≥ 3.3; p ≥ 0.077; η2p ≤ 0.07). Post hoc analysis revealed that the post-PHV group had a higher score than the pre-PHV group. Furthermore, that dynamic balance increased in the post-PHV group after intervention much more in the control post-PHV group. It was concluded that somatic maturation influences dynamic balance performance and that eccentric hamstring training results in greater improvement in balance performance in young male handball players for the post-pubertal group.

Cocreating injury prevention training for youth team handball: bridging theory and practice

Although it is advocated that end-users are engaged in developing evidence-based injury prevention training to enhance the implementation, this rarely happens. The ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ uses an ecological participatory design incorporating the perspectives of multiple stakeholders throughout the project. Within the I-PROTECT project, the current study aimed to describe the development of holistic injury prevention training specifically for youth handball players through using knowledge from both end-users (coaches and players) and researchers/handball experts. Employing action evaluation within participatory action research, the cyclical development process included three phases: research team preparation, handball expert-based preparation and end-user evaluation to develop injury prevention training incorporating both physical and psychological perspectives. To grow the knowledge of the interdisciplinary research team, rethinking was conducted within and between phases based on participants’ contributions. Researchers and end-users cocreated examples of handball-specific exercises, including injury prevention physical principles (movement technique for upper and lower extremities, respectively, and muscle strength) combined with psychological aspects (increase end-user motivation, task focus and body awareness) to integrate into warm-up and skills training within handball practice. A cyclical development process that engaged researchers/handball experts and end-users to cocreate evidence-based, theory-informed and context-specific injury prevention training specifically for youth handball players generated a first pilot version of exercises including physical principles combined with psychological aspects to be integrated within handball practice.

Analysis of the Research Methodology in Spanish Doctoral Theses on Handball. A Systematic Review

The objective of this investigation was to analyze scientific production assessed by indexed doctoral theses in the Ordered Spanish Theses (TESEO) database, on the topic of the sport of handball in Spain. Productivity was analyzed on the basis of variables grouped by contextual information, methodologies and procedures. Seventy-two indexed theses from between 1976 and 2021 were analyzed. A progressive increase was identified in scientific production based on these theses during this period. The scientific disciplines that presented the highest number of theses were Sport Sciences (n = 33) and Sport Pedagogy (n = 19). The main results show that quantitative approaches are the most common (n = 49), doctoral theses using descriptive studies based on systematic observation represent the majority (73%), the predominant type of data collection was the use of cross-sectional studies (70.8%) versus longitudinal studies (26.4%), and the most used sampling method was that of convenience (n = 65). The results make it possible to ascertain the reality of this research topic, the methodological positioning and research tendencies, and to draw the basic lines for development.

Exploring the Effect of Long Naps on Handball Performance and Heart Rate Variability

This study explored the effect of long naps on handball-related performance and assessed the role of the cardiac autonomic nervous system in this process. Eleven male collegiate handball players performed a repeated sequential trial consisting of a 20-m consecutive turnaround run, 10-m run with a load, and shooting the ball into a target. Participants were allocated randomly and sequentially to have a short (20 minutes) nap, long (60 minutes) nap, or no nap. The Pittsburgh Sleep Quality Index was used to assess regular sleep quality. Subjective sleepiness before and after napping was measured using the Karolinska Sleepiness Scale. Heart rate variability was recorded to assess cardiac autonomic nervous function during napping. The Pittsburgh Sleep Quality Index score was correlated with shot accuracy only after long naps (ρ=0.636, r=0.048). A negative correlation was observed between the root mean square of successive differences and average load run time (ρ=−0.929, p<0.001). Long napping was associated with a significant benefit on performance in athletes with poor sleep quality, implying a role of the autonomic nervous system in this regard. Our findings indicate the effect of sleep quality on the endurance and resistance of handball players.

Sport Injuries among Amateur Women and Young Intermediate Level Female Handball Players: A Preliminary Investigation

Background and objectives: Handball is a popular sport among women whose practice can lead to marked health benefits but could also show a high injury risk. There is a lack of research on intermediate level female players. We aimed to identify the prevalence of sport injuries in amateur and young intermediate level female handball players and the potential influence of the sport category. Materials and Methods: A group of cadets, juvenile and senior female players of three handball clubs participating in the Spanish regional league were followed throughout the 2018–2019 season. Information on injuries and exposure was collected via questionnaires. Results: Out of 114 players (34 seniors, 33 juvenile and 47 cadets), 77 of them sustained at least one injury. Most of the injuries were either moderate or severe, regardless of the category. A total of 7.93, 5.93 and 4.16 injuries per 1000 h of exposure were registered in the senior, juvenile and cadet categories respectively. The risk of sustaining an injury was 2.14 times higher for senior players Confidence Interval (CI 95%: 1.51–3.03) and 1.92 higher for juvenile players (CI 95%: 1.32–2.78) when compared with cadets. Conclusions: Senior and young female handball athletes playing at an amateur and intermediate level, are exposed to a substantial risk of sustaining a moderate or severe injury. The players’ category does not seem to have a great impact on the injury rate and on the characteristics of the sport injuries registered.

Prevalence of orofacial trauma and the attitude towards mouthguard use in handball players: A survey in Lorraine, France

BACKGROUND/AIMS

Contact sports such as handball may lead to orofacial injuries that can often be prevented by the use of a properly fitted mouthguard. Several studies have investigated orofacial injuries during contact sports in different countries, but there is a lack of data that is specific for French handball players. Therefore, the aims of this study were to determine the prevalence of orofacial injuries and the proportion of handball players using a mouthguard in Eastern France.

MATERIAL AND METHODS

Data were collected from handball players aged over 15 years old from five handball clubs in the Lorraine Region (Eastern France). A questionnaire containing 26 questions about the general characteristics of participants, orofacial injury experiences, emergency procedures following tooth avulsion, and use of mouthguards was self-administered.

RESULTS

Two hundred and sixty-three handball players, of which 76.8% (202) were males, aged 23 ± 8 years on average, with a mean playing experience of 11 ± 6 years, participated in the study. Among them, 24.7% (65) reported at least one orofacial injury. A total of 237 orofacial injuries was declared. The main types of orofacial injuries including lip, cheek and tongue injuries were reported by 18.6% of handball players (49); dental injuries were reported by 9.9% (26) and injuries to the temporomandibular joint were reported by 4.9% (13). Most participants knew about mouthguards (97.3%, 254) and considered them efficient for preventing dental injuries in handball (95.3%, 242/254), but only 3.0% (8) used them.

CONCLUSION

The prevalence of orofacial injuries among French handball players was high while mouthguards were very rarely used. Information should be provided to handball teams regarding mouthguard use and the management of dental injuries.

Injury Profile in Professional Handball Players During 4 Consecutive Seasons According to Playing Positions: A Longitudinal Study

BACKGROUND

The injury profile of each playing position in handball is a key factor in being able to improve the injury risk management process. Therefore, the aim of this study was to longitudinally analyze the differences in professional handball players' injury profile according to their playing position (ie, goalkeeper, back, wing, and line).

HYPOTHESIS

Injury incidence and burden would be higher in back players compared with the other playing positions, while ligament and knee would be the most common injury type and location.

STUDY DESIGN

Prospective cohort design.

LEVEL OF EVIDENCE

Level 4.

METHODS

Sixty-eight male handball players belonging to the same professional team participated in this study over 4 consecutive seasons. Injury incidence and injury burden were recorded as well as the severity, type, and location following the International Olympic Committee consensus statement.

RESULTS

Although nonsignificant differences in injury incidence were found according to playing position (rate ratios [RRs] from 0.43 to 2.47; P > 0.05), back players reported the highest burden (60.65 absence days/1000 h; RR from 0.12 to 7.75;P < 0.05), with wing players showing a greater burden (54.29 absence days/1000 h; RR from 0.09 to 4.91; P < 0.05) in comparison with goalkeepers (12.19 absence days/1000 h) and line players (13.10 absence days/1000 h). Muscle/tendon injuries and sprains presented higher incidence and burden than other type of injuries, and a greater incidence and burden was reported for knee injuries in all playing positions.

CONCLUSION

The highest injury incidence and injury burden is in back players in professional handball.

CLINICAL RELEVANCE

This study provides comprehensive information on the injury profile of professional handball players, which can be useful for strength and conditioning coaches when developing specific injury risk management programs.

Epidemiology of injuries in elite Korean handball athletes: a prospective cohort study

BACKGROUND

To report injury patterns associated with training activities of South Korean elite handball athletes.

METHODS

We prospectively collected data (stratified by sex, handball position, and injury location) on site from elite handball athletes between January and December 2019 at the Korea Training Center, South Korea. We used χ2 tests and one-way analysis of variance to compare groups. Simple linear regression was conducted to determine associations between pain score and recovery time.

RESULTS

We included 188 (96 male and 92 female) athletes who sustained 767 injuries (annual average, 4.08 injuries/athlete) during the study. Female athletes had a higher (p<0.001) injury incidence rate (6.21/1000 h) than male athletes (4.39/1000 h). Most injuries occurred in the lower extremities (50.2%). The injured body areas differed by handball position (p<0.001), and injury severity differed according to sex (p<0.001), with injuries in men typically resulting in a longer recovery time. Pain score and recovery time differed (both p<0.001) depending on the injured tissue type. Pain score was the highest and recovery time longest for ligament injuries; muscle injuries resulted in a high pain score but a relatively short recovery time. An increase in pain score of 1 was associated with an increase in recovery time of approximately 1.59 days.

CONCLUSIONS

We believe that our data increase the understanding of the types and severity of injuries sustained by elite Korean handball athletes. These data should be incorporated into programs that aim to reduce the incidence of sports injuries and enhance athletic performance.

Epidemiology of injuries in female and male senior Slovenian handball leagues

BACKGROUND

Handball is associated with a high frequency of injuries due to unexpected situations, external disturbances of movement and extreme positions of body segments. The purpose of this study was to identify and analyze injuries among female and male players from all five senior Slovenian handball leagues in the season 2010/2011.

METHODS

We conducted a retrospective epidemiological study using a questionnaire. Data were collected between February and May 2012. Descriptive analysis is provided.

RESULTS

Forty-five percent of all the players were injured, reporting 92 injuries. 0.58 injuries/player occurred, 57 (62%) in females and 35 (38%) in males. Injury incidence in females (27.7 injuries/1000 hours match, 0.97 injuries/1000 hours training) was higher than in men (10.6 injuries/1000 hours match, 0.5 injuries/1000 hours training), respectively. The left- and right-back players were injured most often (41%). Sprain was the most common injury type (55%). Most injuries were severe (29%). The lower limb was injured most frequently (62%). Ankle was injured the most commonly (35%), but ankle injuries were in most cases moderate (38%). More than 70% of knee injuries and 50% of shoulder injuries were severe. In 33%, cause of injury was contact with an opponent/teammate. Thirty-six percent of players reported shoulder and 36% ankle overuse syndromes.

CONCLUSIONS

Present findings showed a higher incidence of injuries in female than in male senior Slovenian handball players in the 2010/2011 season. Preventive programs should focus not only on the acute ankle and knee injuries, but also on overuse syndromes of the shoulder and ankle.

Epidemiology of Injuries in Ultimate (Frisbee): A Systematic Review

Ultimate is a high-intensity, non-contact team sport played with a flying disc (e.g., frisbee). Despite the growing popularity of ultimate worldwide, there is limited information about the epidemiology of injury in the sport. The purpose of this review is to provide a comprehensive overview and synthesis of the literature on the epidemiology of injury in ultimate. A comprehensive search of the literature was conducted in five electronic databases (i.e., MEDLINE, Embase, AMED, SPORTDiscus, and AusportMed). All databases were searched from inception to 1 July 2020. A total of eleven studies were included and qualitatively synthesized. Injury incidence rate estimates ranged from 0.4 to 84.9 injuries per 1000 athlete-exposures. The lifetime prevalence of any injury and concussion were 100% and 26%, respectively. The most commonly injured body region was the lower limb, with the knee and thigh being the most frequently injured anatomical locations. The most frequent injury types were muscle injuries and superficial contusions. The most common injury situation was direct contact with another player. There is a substantial risk of injury in ultimate, in particular muscle strains and joint sprains to the knee and shoulder areas. Development and implementation of effective, sport-specific injury prevention initiatives, including improved injury risk management and sport safety culture, should be a priority to reduce the burden of injury in ultimate.

Effects of Nutrition Education Interventions in Team Sport Players. A Systematic Review

Considering nutrition education interventions have been frequently implemented in team sport athletes and have shown promising results, this study aimed to summarize the effects of nutrition education interventions on eating habits, nutrition knowledge, body composition, and physical performance in team sport athletes. A systematic review was conducted using the following databases: PubMed/MEDLINE, Web of Science and SPORTDiscus. A total of 14 studies met the inclusion criteria for the review. The methodological quality of included studies was evaluated, and each study was assessed according to the analyzed variables (i.e., eating habits, nutrition knowledge, body composition, and physical performance). Most studies showed improvements in or maintenance of variables used to indicate eating habits, nutrition knowledge, and body composition. However, limited studies examined the effect of nutrition education interventions on physical performance, with existing studies demonstrating disparate results. These findings suggest implementation of nutrition education interventions in team sport athletes could be an effective strategy to improve their eating habits, nutrition knowledge, and body composition. Due to the heterogeneity across the included studies regarding sport modality, competition level, age, and sex of the athletes investigated, as well as the intervention type adopted (i.e., online or face-to-face), it is difficult to establish optimal nutrition education interventions for each analyzed variable.

Repeated Sprint Ability Demands in U16 to U19 Highly Trained Handball Players Concerning Playing Position

The aim of the study was to determine anaerobic capacity and characterize changes in repeated sprint ability (RSA) within youth elite handball players. For this study, 142 male athletes (17.1 ± 0.9 years) were recruited from a handball sports high school and performed the RSA test on a cycle ergometer, including five 6 s all-out efforts separated by 24 s passive breaks. Maximal (P_max) and mean (P_mean) power, highest (W_max), and total work (W_tot) as well as power (P_dec) and work (W_dec) decrement were measured. Significant differences in RSA were noted in relation to age (greater values of P_max, P_mean, W_tot, W_dec, and P_dec in U19 than U17 as well as greater values of P_max, W_tot, W_max, W_dec, and P_dec in U19 than U16 (p < 0.05)) and playing position (wing players had greater W_tot than pivot, 269 vs. 243 (J/kg) (p < 0.05), and wing players differed significantly in absolute and relative power from athletes of other positions). RSA depends on playing position and age in groups of youth handball players and the RSA test can be helpful in the selection of athletes for a playing position. The article introduces normative values for elite youth handball players, empowering coaches in the evaluation of anaerobic abilities and selection.