The Most Common Handball Injuries: A Systematic Review

Descriptive study on injuries and illness in Dutch female adolescent and young adult handball players

Objective

This study describes the magnitude and burden of injuries and illnesses in elite Dutch female adolescent and young adult handball players.

Design

A retrospective open cohort study.

Methods

10 consecutive seasons were studied using a database including all injuries and illnesses needing medical attention. In total, 102 handball players, who participated in a full-time programme of the Dutch Handball Academy between August 2009 and July 2019, were included. Injuries were classified according to the consensus statement of the International Olympic Committee. Exposure hours were categorised into training and competition exposure. Training exposure included all handball and strength and conditioning sessions. Burden was defined as the injury duration in days divided by the total exposure hours.

Results

In total, 916 injuries in 101 players and 95 illnesses in 59 players were reported. The average seasonal prevalence was 83.2% for acute injuries and 78.7% for repetitive injuries. The overall incidence rate was 4.24/1000 exposure hours with an incidence of 23.06/1000 competition hours and 2.19/1000 practice hours. The highest average seasonal prevalence and burden were observed for repetitive injuries of the lumbosacral spine, knee and lower leg and acute injuries of the ankle and knee.

Conclusion

High injury prevalence proportions and competition incidence rates were observed. Repetitive injuries of the lumbosacral spine, knee and lower leg, as well as acute injuries of the knee and ankle, formed the largest problem. Future prevention programmes in elite Dutch adolescent and young adult female handball players should therefore focus on these injuries.

Sports-Related Injuries in Deaf Competitive Squad Athletes-Results of a Retrospective Self-Assessment

BACKGROUND

Deaf squad athletes regularly participate in national/international competitions and most prepare for competitions in clubs with hearing athletes. Hearing loss is associated with difficulties in balance control which may impair functionality. The aim of this study is to provide epidemiological data on sports injuries in deaf squad athletes.

METHODS

In this retrospective study, data on main sport, training and competitions, injury rates, and downtimes were collected. Questionnaires from n = 65 athletes (n = 15 females, n = 50 males; age 28.00 ± 0.40 years) were finally analyzed. All injuries during the athlete's career within nine body regions were recorded. The influence of contact sports, supervision by Olympic Training Center (OSP), and hearing aids on injury rates and downtimes were analyzed.

RESULTS

An amount of 89.20% were additionally registered in a regular sports club. A total of 1430 injuries were recorded during 465,400 training hours (3.07 injuries/1000 training hours). The highest prevalences were found for hand/fingers (43.00%) and ankle/foot (14.00%). Contact sport athletes had higher injury rates and longer downtimes (5.66 versus 1.28 injuries/1000; p < 0.001; 2.45 versus 1.11 weeks/1000; p = 0.011). OSP athletes showed lower injury rates (0.92 versus 4.38 injuries/1000, p = 0.004). Longer downtimes were recorded for athletes without hearing aids during training (2.29 weeks/1000 versus 0.96 weeks/1000; p = 0.045).

CONCLUSIONS

Deaf athletes are exposed to additional training and competition in hearing sports. The negative impact of contact sports may be attributed to hearing loss. Hearing aids in training seem to be protective. Athletes should consider supervision by OSP. The results of this study may help to improve treatment and integration of deaf athletes into hearing sports.

Health problems and injury management in adolescent handball: the Safeplay one-season cohort study of 679 players

OBJECTIVES

To assess (1) the 1-year prevalence of previous shoulder, knee and ankle injuries; (2) the in-season prevalence proportion (prevalence) of injuries and illnesses, injury incidence rate (ir) and injury burden (product of ir and weeks with injuries); (3) initial injury management strategies.

METHODS

We conducted a cohort study of 679 highest-division Danish handball players aged 14-18. Players self-reported past-year shoulder, knee and ankle injuries at baseline, and weekly information on any handball-related injuries (irrespective of time loss and medical attention), illnesses, exposure hours and injury management over 31 weeks.

RESULTS

At baseline, 46% (95% CI 42% to 49%) of the players reported a past-year shoulder, knee or ankle injury. The weekly average injury and illness prevalence was 21% (95% CI 19% to 23%) and 2% (95% CI 1.7% to 2.3%), respectively, and the ir was 9.4 (95% CI 8.7 to 10.2)/1000 hours. Females experienced the highest injury burden from knee injuries (ir: 1.7 (95% CI 1.3 to 2.2) × 6.7 (95% CI 4.7 to 8.7) weeks with injury/1000 hours), while males experienced the highest injury burden from shoulder injuries (ir: 1.3 (95% CI 1.0 to 1.7) × 5.7 (95% CI 3.6 to 7.8) weeks with injury/1000 hours). Health professionals were consulted in 58% (95% CI 54% to 62%) of injuries, players independently made the return to sport decision in 44% (95% CI 37% to 51%) of injury recurrences, and used analgesics, mainly (91% (95% CI 85% to 95%)) sourced from home, in 24% (95% CI 21% to 28%) of injuries.

CONCLUSION

Almost half of highest-division adolescent Danish handball players reported a previous past-year shoulder, knee or ankle injury. Any time during the season, 21% reported an injury and 2% an illness. The highest injury burdens were from knee injuries in females and shoulder injuries in males. Health professionals often managed injuries, but players frequently made return to sport decisions independently and commonly used analgesics sourced from home.

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.