The Most Common Handball Injuries: A Systematic Review

Upper Crossed Syndrome and Scapulae Upper-Trapping: A Mesotherapy Protocol in Cervicoscapulobrachial Pain-The 8:1 Block

Upper Crossed Syndrome (UCS), described by Vladimir Janda, is characterized by postural changes involving the cervical spine and trunk, leading to biomechanical limitations and cervicoscapulobrachial pain. This study proposes a mesotherapy protocol, termed the 8:1 block, to address cervicoscapulobrachialgia by targeting the scapulae and associated musculature. The scapula, central to shoulder girdle kinematics, often exhibits dyskinesis and muscular imbalances, notably the pattern referred to as scapular upper trapping (SUT). SUT involves scapular elevation, medial rotation, and shoulder protraction, contributing to cervicobrachial pain. The protocol includes a comprehensive assessment of muscle tone changes and biomechanical considerations, highlighting the importance of the scapula in upper limb movement and posture. Key anatomical changes involve tightened upper trapezius, levator scapulae, and pectoralis minor muscles, with weakened middle trapezius and serratus anterior. The mesotherapy approach targets these imbalances through specific injection points to alleviate muscle tension and correct postural deviations. Case studies from our clinic demonstrate the protocol's effectiveness in reducing pain and restoring scapular biomechanics. Patients reported significant improvements in pain relief and functional outcomes, underscoring the clinical utility of the 8:1 block in treating cervicoscapulobrachialgia. This protocol offers a feasible, cost-effective intervention that enhances the efficacy of traditional therapeutic exercises by addressing underlying muscular and biomechanical dysfunctions. In conclusion, the 8:1 block mesotherapy protocol provides a novel approach to managing cervicoscapulobrachial pain by focusing on scapular biomechanics and muscle tension. Further studies are needed to validate these findings and refine the protocol for broader clinical application.

The Effects of Proprioceptive Exercises on Postural Control in Handball Players with Chronic Ankle Instability-A Non-Randomized Control Trial

BACKGROUND

This paper aims to investigate the impact of proprioceptive exercises on postural control in handball players with chronic ankle instability.

METHODS

The research participants (n = 22) were divided into two groups: the experimental group (n = 11) and the control group (n = 11). Chronic ankle instability was diagnosed using the Identification of Functional Ankle Instability (IdFAI) questionnaire, while postural control was evaluated with the Iso-Shift stabilometric platform. The intervention consisted of a 15-week proprioceptive exercise program, with sessions performed three times a week. The rehabilitation protocol was conducted at the start of each training session, immediately following the warm-up.

RESULTS

The data were analyzed using the Wilcoxon and Mann-Whitney U tests. Both groups improved their score on the Identification of Functional Ankle Instability (IdFAI) questionnaire (IdFAI_CG, p < 0.011; IdFAI_EG, p < 0.003) and reduced the number of ankle sprains (NS_EG, p < 0.008). Also, the experimental group had better results for the following tests: ellipse area with open eyes on the left leg (EA_I-OE_L, p < 0.009), ellipse area with closed eyes on the left leg (EA_I-CE_L, p < 0.033), anteroposterior deviation with open eyes on the left leg (APD_I-OE_L, p < 0.023), and the initial and final number of ankle sprains (NS_I, p < 0.01; NS_F, p < 0.024).

CONCLUSIONS

Athletes who suffer from chronic joint instability are more likely to experience severe postural deviations than those who do not have this condition. Proprioceptive exercises had a positive impact on postural control in both groups, but the experimental group showed a greater improvement.

Test-retest reliability of lower limb muscle strength, jump and sprint performance tests in elite female team handball players

PURPOSE

This study aimed to assess the reliability of lower limb muscle function (knee extensor/flexor peak torque, rate of torque development (RTD), impulse, and countermovement jump (CMJ) performance) and sprint performance (acceleration capacity).

METHODS

CMJ performance was evaluated on a force plate. MVIC, RTD and impulse variables were investigated using a portable isometric dynamometer and sprint performance was assessed with dual-beam photocells in elite female athletes.

RESULTS

CMJ test variables maximal vertical jump height, peak and mean power, concentric work, and body center of mass displacement demonstrated good-to-excellent test-retest correlations between Test 1 and Test 2 (ICC ≥ 0.70, CWw-s = 3.4-11.0%). Peak MVIC torque for the knee extensors and flexors demonstrated excellent test-retest correlations (both ICC = 0.84) along with CVw-s values of 6.8 and 6.0%, respectively. Late-phase (0-100 ms, 0-200 ms) RTD for the knee flexors demonstrated excellent test-retest correlations (ICC = 0.89-0.91, CVw-s = 4.8-8.5%). Sprint times at 10- and 20-m demonstrated excellent test-retest reproducibility (ICC = 0.83 and ICC = 0.90, respectively) with CVw-s values of 1.9 and 1.5%. For 5-m sprint times, test-retest reproducibility was good (ICC = 0.71) with CVw-s of 2.8%. Sprint testing performed while dribbling a handball improved (p < 0.05) from test to retest at 5-, 10- and 20-m.

CONCLUSION

In conclusion, the force plate, the mobile isometric dynamometer, and dual-beam photocells provide reproducible tools for field-based testing of countermovement jump performance, knee extensor and flexor strength and sprint performance.

Is an Exercise-Based Injury-Prevention Program Effective in Team Handball Players? A Systematic Review and Meta-Analysis

OBJECTIVE

To assess the effectiveness of exercise-based injury-prevention programs in preventing sports injuries in team handball players.

DATA SOURCES

Scopus, PubMed, Web of Science, SPORTDiscus, and CINAHL from inception until April 2023.

STUDY SELECTION

Studies were included if they were randomized controlled trials or prospective cohort studies, contained a population of competitive team handball players, included an intervention designed specifically to prevent or reduce the risk of team handball injuries, and reported injury incidence rates specific to team handball players. Two researchers independently evaluated studies for inclusion and assessed their methodological quality.

DATA EXTRACTION

Study design, intervention details, participant characteristics, and the number of injuries in each group were extracted from each study by 2 independent researchers. The outcome of interest was the incidence rate of injury. Injury data were classified into 5 groups: shoulder injuries, lower extremity injuries, knee injuries, anterior cruciate ligament injuries, and ankle injuries. Extracted data were analyzed using a random-effects model to compute the overall effect estimates of injury-prevention programs in reducing the risk of injuries. Odds ratios (ORs) with 95% CIs were calculated based on the number of injuries in each group.

DATA SYNTHESIS

Meta-analyses were conducted independently for each injury classification. Results indicated that prevention programs reduced the risk of shoulder injuries (OR = 0.60; 95% CI = 0.42, 0.85; P = .004), lower extremity injuries (OR = 0.59; 95% CI = 0.37, 0.95; P = .03), knee injuries (OR = 0.53; 95% CI = 0.35, 0.78; P = .002), anterior cruciate ligament injuries (OR = 0.66; 95% CI = 0.45, 0.96; P = .03), and ankle injuries (OR = 0.57; 95% CI = 0.40, 0.81; P = .002) in team handball players.

CONCLUSIONS

In team handball players, injury-prevention programs appear to effectively reduce the risk of shoulder, lower extremity, knee, ankle, and anterior cruciate ligament injuries.

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.

Effects of Additional Plyometric Training on the Jump Performance of Elite Male Handball Players: A Systematic Review

Handball is one of the most popular team sports around the world that has become physically very demanding, related to both competitions and daily training sessions. Optimal training programs are necessary to improve performance, especially when taking into account the frequency of jump shots (vertical jumps) and handball feints (changes of directions) during daily training. The main objective of the present study is to review the available literature systematically, and to determine what are the effects of additional plyometric training on handball players' vertical jump abilities. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, six studies were selected after a systematic search through four digital databases: Web of Science, PubMed, Scopus, and ScienceDirect. The available scientific articles show that plyometric training alone or in combination with standard handball training, lasting at least six weeks, and including two training sessions per week, contributes to improving the performance of elite- or national-level handball players. Plyometric training is recommended to improve performance, as well as to maintain explosive strength parameters during the season.

Sports Injuries of a Portuguese Professional Football Team during Three Consecutive Seasons

Professional football players are exposed to high injury risk due to the physical demands of this sport. The purpose of this study was to characterize the injuries of a professional football team in the First Portuguese League over three consecutive sports seasons. Seventy-one male professional football players in the First Portuguese Football League were followed throughout the sports seasons of 2019/2020, 2020/2021, and 2021/2022. In total, 84 injuries were recorded. Each player missed an average of 16.6 days per injury. Lower limbs were massively affected by injuries across all three seasons, mainly with muscular injuries in the quadriceps and hamstrings and sprains in the tibiotarsal structure. Overall, the injury incidence was considerably higher in matches than in training. The two times of the season that proved most conducive to injuries were the months of July and January. Our results emphasize the importance of monitoring sports performance, including injury occurrence, and assisting in identifying risk factors in professional football. Designing individualized training programs and optimizing prevention and recovery protocols are crucial for maximizing this global process.