Leonardo Intelangelo, Ignacio Lassaga, Elias Gonzalo, Cristian Mendoza, Juan Manuel Ormazabal, Iván Roulet, Nicolás Bevacqua, Daniel Jerez-Mayorga
{"title":"力量是过度使用性肩伤的主要危险因素吗？296名业余高空运动员的队列研究。","authors":"Leonardo Intelangelo, Ignacio Lassaga, Elias Gonzalo, Cristian Mendoza, Juan Manuel Ormazabal, Iván Roulet, Nicolás Bevacqua, Daniel Jerez-Mayorga","doi":"10.1177/19417381241298287","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Shoulder pain is one of the most common musculoskeletal complaints in overhead athletes. This study investigated the prevalence of the main risk factors and sex differences related to the development of shoulder pain in a cohort of amateur overhead athletes.</p><p><strong>Hypothesis: </strong>The external rotation/internal rotation (ER/IR) isometric strength ratio <0.75% is the most prevalent risk factor associated to overuse shoulder injuries in both sexes.</p><p><strong>Study design: </strong>Cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A total of 296 (147 male and 149 female) amateur overhead athletes from handball, volleyball, and water polo participated in this cross-sectional study. Isometric strength, rotational range of motion, and scapular control were analyzed bilaterally. The measurements and motions were randomized between sides.</p><p><strong>Results: </strong>The ER/IR isometric strength ratio deficit among the disciplines was presented in 264 and 229 out of 296 athletes in the dominant and nondominant sides, respectively. Normalized isometric strength showed significant differences for dominant (<i>P</i> < 0.01; ε² = 0.47) and nondominant IR (<i>P</i> < 0.01; ε² = 0.60). No significant differences were observed between dominant (<i>P</i> = 0.44; ε² = 0.05) and nondominant ER (<i>P</i> = -0.24; ε² = 0.07). The prevalence of glenohumeral IR deficit (GIRD) (<i>P</i> = 0.81) and total arc of motion differences (TAMD) (<i>P</i> = 0.39) was low, with no difference between sexes. Male (16.3%) and female (12.1%) athletes had low rate of obvious scapular dyskinesis in their dominant shoulders.</p><p><strong>Conclusion: </strong>Muscle strength was the most prevalent risk factor. The ER/IR ratio imbalance was present in both sides, without sex differences. Risk factors such as scapular dyskinesis, GIRD, and TAMD were present in low percentages, without sex differences.</p><p><strong>Clinical relevance: </strong>It is advisable to implement shoulder exercises to strengthen ER muscles to decrease differences between internal and external rotators and prevent injuries in overhead athletes.</p>","PeriodicalId":54276,"journal":{"name":"Sports Health-A Multidisciplinary Approach","volume":" ","pages":"19417381241298287"},"PeriodicalIF":2.7000,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664554/pdf/","citationCount":"0","resultStr":"{\"title\":\"Is Strength the Main Risk Factor of Overuse Shoulder Injuries? A Cohort Study of 296 Amateur Overhead Athletes.\",\"authors\":\"Leonardo Intelangelo, Ignacio Lassaga, Elias Gonzalo, Cristian Mendoza, Juan Manuel Ormazabal, Iván Roulet, Nicolás Bevacqua, Daniel Jerez-Mayorga\",\"doi\":\"10.1177/19417381241298287\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Shoulder pain is one of the most common musculoskeletal complaints in overhead athletes. This study investigated the prevalence of the main risk factors and sex differences related to the development of shoulder pain in a cohort of amateur overhead athletes.</p><p><strong>Hypothesis: </strong>The external rotation/internal rotation (ER/IR) isometric strength ratio <0.75% is the most prevalent risk factor associated to overuse shoulder injuries in both sexes.</p><p><strong>Study design: </strong>Cohort study.</p><p><strong>Level of evidence: </strong>Level 3.</p><p><strong>Methods: </strong>A total of 296 (147 male and 149 female) amateur overhead athletes from handball, volleyball, and water polo participated in this cross-sectional study. Isometric strength, rotational range of motion, and scapular control were analyzed bilaterally. The measurements and motions were randomized between sides.</p><p><strong>Results: </strong>The ER/IR isometric strength ratio deficit among the disciplines was presented in 264 and 229 out of 296 athletes in the dominant and nondominant sides, respectively. Normalized isometric strength showed significant differences for dominant (<i>P</i> < 0.01; ε² = 0.47) and nondominant IR (<i>P</i> < 0.01; ε² = 0.60). No significant differences were observed between dominant (<i>P</i> = 0.44; ε² = 0.05) and nondominant ER (<i>P</i> = -0.24; ε² = 0.07). The prevalence of glenohumeral IR deficit (GIRD) (<i>P</i> = 0.81) and total arc of motion differences (TAMD) (<i>P</i> = 0.39) was low, with no difference between sexes. Male (16.3%) and female (12.1%) athletes had low rate of obvious scapular dyskinesis in their dominant shoulders.</p><p><strong>Conclusion: </strong>Muscle strength was the most prevalent risk factor. The ER/IR ratio imbalance was present in both sides, without sex differences. Risk factors such as scapular dyskinesis, GIRD, and TAMD were present in low percentages, without sex differences.</p><p><strong>Clinical relevance: </strong>It is advisable to implement shoulder exercises to strengthen ER muscles to decrease differences between internal and external rotators and prevent injuries in overhead athletes.</p>\",\"PeriodicalId\":54276,\"journal\":{\"name\":\"Sports Health-A Multidisciplinary Approach\",\"volume\":\" \",\"pages\":\"19417381241298287\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-12-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664554/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sports Health-A Multidisciplinary Approach\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/19417381241298287\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SPORT SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sports Health-A Multidisciplinary Approach","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/19417381241298287","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
Is Strength the Main Risk Factor of Overuse Shoulder Injuries? A Cohort Study of 296 Amateur Overhead Athletes.
Background: Shoulder pain is one of the most common musculoskeletal complaints in overhead athletes. This study investigated the prevalence of the main risk factors and sex differences related to the development of shoulder pain in a cohort of amateur overhead athletes.
Hypothesis: The external rotation/internal rotation (ER/IR) isometric strength ratio <0.75% is the most prevalent risk factor associated to overuse shoulder injuries in both sexes.
Study design: Cohort study.
Level of evidence: Level 3.
Methods: A total of 296 (147 male and 149 female) amateur overhead athletes from handball, volleyball, and water polo participated in this cross-sectional study. Isometric strength, rotational range of motion, and scapular control were analyzed bilaterally. The measurements and motions were randomized between sides.
Results: The ER/IR isometric strength ratio deficit among the disciplines was presented in 264 and 229 out of 296 athletes in the dominant and nondominant sides, respectively. Normalized isometric strength showed significant differences for dominant (P < 0.01; ε² = 0.47) and nondominant IR (P < 0.01; ε² = 0.60). No significant differences were observed between dominant (P = 0.44; ε² = 0.05) and nondominant ER (P = -0.24; ε² = 0.07). The prevalence of glenohumeral IR deficit (GIRD) (P = 0.81) and total arc of motion differences (TAMD) (P = 0.39) was low, with no difference between sexes. Male (16.3%) and female (12.1%) athletes had low rate of obvious scapular dyskinesis in their dominant shoulders.
Conclusion: Muscle strength was the most prevalent risk factor. The ER/IR ratio imbalance was present in both sides, without sex differences. Risk factors such as scapular dyskinesis, GIRD, and TAMD were present in low percentages, without sex differences.
Clinical relevance: It is advisable to implement shoulder exercises to strengthen ER muscles to decrease differences between internal and external rotators and prevent injuries in overhead athletes.
期刊介绍：
Sports Health: A Multidisciplinary Approach is an indispensable resource for all medical professionals involved in the training and care of the competitive or recreational athlete, including primary care physicians, orthopaedic surgeons, physical therapists, athletic trainers and other medical and health care professionals.
Published bimonthly, Sports Health is a collaborative publication from the American Orthopaedic Society for Sports Medicine (AOSSM), the American Medical Society for Sports Medicine (AMSSM), the National Athletic Trainers’ Association (NATA), and the Sports Physical Therapy Section (SPTS).
The journal publishes review articles, original research articles, case studies, images, short updates, legal briefs, editorials, and letters to the editor.
Topics include:
-Sports Injury and Treatment
-Care of the Athlete
-Athlete Rehabilitation
-Medical Issues in the Athlete
-Surgical Techniques in Sports Medicine
-Case Studies in Sports Medicine
-Images in Sports Medicine
-Legal Issues
-Pediatric Athletes
-General Sports Trauma
-Sports Psychology
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