Shoulder Internal Rotator Strength as Risk Factor for Shoulder Pain in Volleyball Players.

The aim of this study was to identify the intrinsic factors that could increase risk of shoulder pain in adolescent volleyball players. Twenty-eight young male volleyball players (between 14 and 18 years old) participated in this study. Athletes were submitted to: isokinetic muscle strength assessment of shoulder rotator muscles, ball service speed assessment, anterior and posterior drawer test, apprehension test, groove sign and scapular dyskinesia test. Athletes were followed for 16 weeks to monitor the presence of shoulder pain. All athletes were submitted to the same training protocol. During the 16 weeks, 28.5% of the athletes (n=8) experienced shoulder pain in the dominant limb higher than 3 according to Numerical Rating Scale criteria; 71.5% of the athletes (n=20) did not experience pain, or pain equal or lower than 3. The main result of our study was that the odds of feeling pain higher than 3 was significantly higher among players who presented higher values for internal rotation peak torque (OR=1.113, CI 95%=1.006 to 1.232 and p=0.038). The odds of feeling pain increased by 11% for every N·m of the internal rotator muscles. Pre-season isokinetic rotator strength assessments can help identify adolescent volleyball players at increased risk of a shoulder injury.

Shoulder Isokinetic Strength Balance Ratio in Overhead Athletes: A Cross-Sectional Study.

BACKGROUND: Studies have grouped different overhead sports and evaluated together the isokinetic strength of shoulder internal (IR) and external (ER) rotator muscles. However, muscular adaptations could be a consequence of the specific sport, and some strength imbalance between these muscles may exist as a consequence of the muscular demand unique to the sport. Therefore, grouping different overhead sports together may not be adequate. PURPOSE: To compare strength balance ratios between different overhead sports (volleyball, handball, swimming, judo, baseball, softball, functional movements performed at high-intensity interval training, and tennis) with a control athletic group (no overhead group). STUDY DESIGN: Cross-sectional study. METHODS: A total of 237 athletes were submitted to isokinetic shoulder strength tests. The isokinetic concentric and eccentric peak torque values of shoulder internal IR and external ER rotator muscles were measured. Conventional (CR) and functional strength ratios (FR) were calculated. RESULTS: There were no significant differences between the sports for the CR in the male group. Female softball athletes (90.4±13.6%) had a significantly higher CR than judo (67.3±6.9%), volleyball (74.9±15.9%), and swimming athletes (70.3±8.7%). In the female group, judo athletes had lower FR values (0.76±0.19) than soccer athletes (1.31±0.35), volleyball athletes (1.24±0.27), functional movements performed at high intensity (1.10±0.1), and softball athletes (1.40±0.39). Female handball athletes also had a lower FR (0.99±0.25) than soccer athletes (1.31±0.35) and softball athletes (1.40±0.39). Male handball (0.90±0.23), tennis (0.86±0.30), and judo (0.68±0.22) athletes had lower FR values than soccer athletes (1.20±0.21) and volleyball athletes (1.25±0.28). CONCLUSIONS: CR for males may be analyzed together, as there were no significant differences between them. However, for females, the CR for softball athletes should be analyzed individually. As there were several differences between the overhead sports according to the FRs, the authors suggest caution in grouping overhead athletes across multiple sports. These results could have important implications for the design of injury prevention and rehabilitation programs associated with the shoulder joint in overhead sports. LEVEL OF EVIDENCE: 3.

Knee isokinetic muscle strength and balance ratio in female soccer players of different age groups: a cross-sectional study.

Background: As a consequence of years of soccer training and sexual maturation, there is an increase in lower body muscle mass and strength especially in the knee extensors and flexors muscles. In this context, the lack of knee joint stability, resulting from strength imbalance between knee extensor and flexors muscles, has been associated with knee injuries. The aim of this study was to compare the knee flexor and extensor muscle peak torque, average power, contralateral deficit, conventional and functional balance ratios of female soccer players from different age groups.Methods: Sixty-six female soccer players were divided into four groups: under 13 (U13), under 15 (U15), under 17 (U17) years old and professional (PRO). Flexor and extensor knee muscle strength in concentric and eccentric actions of both limbs were assessed using isokinetic dynamometer.Results: For the dominant limb, the knee concentric extensor muscles peak torques, assessed at 60 and at 240 deg/sec, and the average power of U15 group were significantly higher than U13 group. Extensor muscle average power of the PRO group was higher than U17. Dominant knee flexor average power of U15 was significantly higher than the U13 group. Peak torque at 60 deg/sec and 240 deg/sec and average power of the PRO group were higher than the U17 group. No differences were found regarding the eccentric action for flexor and extensor muscles. Conventional and functional balance ratios were similar among all age group, except for U13, which presented higher values than the U15 group for the dominant limb.Conclusions: The greatest improvement in muscular performance occur when the athlete starts practicing soccer (after U13) and when they become professional (after U17) and the balance ratios, and muscle balance ratios remain stable in all age groups, although they are below the recommended level in the literature, which may increase the risk for lower limb injury.

Profiling Isokinetic Strength of Shoulder Rotator Muscles in Adolescent Asymptomatic Male Volleyball Players.

The aim of the study was to describe the strength symmetry of internal and external rotator muscles and the conventional and functional strength balance ratios between these muscles in adolescent male volleyball players. Twenty-eight male adolescent volleyball players (15.5 ± 1.1 years (15⁻17 years); 73.2 ± 10.9 kg (55.3⁻100.1 kg) and 184.9 ± 8.4 cm (170⁻209 cm)) participated in this cross-sectional study. Concentric and eccentric peak torque of external and internal rotator muscles were measured, and conventional and functional strength balance ratios were calculated. The dominant limb presented significantly higher values for peak torque than the non-dominant limb of internal rotator muscles at concentric action assessed at 60°/s (48.7 ± 13.7 Nm and 43.9 ± 11.6 Nm, p = 0.01 and d value = 0.37) and at 240°/s (44.7 ± 11.2 Nm and 41.1 ± 11.0 Nm, p = 0.03 and d = 0.32). However, there was no difference in the peak torque of external rotator muscle between limbs for either angular speed. Regarding strength balance ratios, neither conventional (74.8 ± 14.3 for dominant limb and 80.1 ± 14.0 for non-dominant limb, p = 0.06 and d = 0.37) nor functional ratio (1.2 ± 0.4 for dominant limb and 1.3 ± 0.5 for non-dominant limb, p = 0.06 and d = 0.22) presented significant contralateral differences. Despite the short practice time, adolescent male volleyball athletes already have significant contralateral differences for internal rotator muscles and conventional ratio tends to be asymmetrical. Thus, preventive shoulder-strengthening programs, focused on the internal rotator muscles of the non-dominant limb, aiming to correct contralateral deficiency and conventional ratio, may be warranted for this population in the process of biological growth, maturation and development.

Sport injuries treated at a physiotherapy center specialized in sports / Lesões esportivas tratadas em um centro de fisioterapia especializado em esportes

Abstract Introduction: The risk of injuries related to physical activity and sports may increase if there is predisposition, inappropriate training and/or coach guidance, and absence of sports medicine follow-up. Objective: To assess the frequency of injuries in athletes treated at a physiotherapy center specialized in sports. Methods: For the data collection was carried out the survey of injuries in records of athletes treated in eight years of activities. The data collected included: characteristics of patients, sport, injury kind, injury characteristics and affected body part. Results: From 1090 patient/athlete records, the average age was 25 years old, the athletes were spread across 44 different sports modalities, being the great majority men (75%). The most common type of injury was joint injury, followed by muscular and bone injuries. Chronic injury was the most frequent (47%), while the most common body part injured was the knee, followed by ankle and shoulder. Among all the sports, soccer, futsal, and track and field presented the highest number of injured athletes, respectively. Conclusion: Soccer was the most common sport among the injured athletes, injury kind most frequent was joint injuries and knee was the body part most injured. Chronic injuries were the most common.

Resumo Introdução: O risco de lesões relacionadas à atividade física e ao esporte aumenta quando existe predisposição, falta de treinamento ou orientação e em atividades na qual não houve preparação adequada. Objetivo: Verificar a frequência das lesões em atletas atendidos por um serviço especializado em fisioterapia esportiva. Métodos: Para a coleta de dados foi realizado o levantamento das lesões nos prontuários de atletas atendidos em oito anos de atividades. Foram coletados da ficha de avaliação: características dos pacientes, modalidade esportiva, tipos e características das lesões e o segmento corporal acometido. Resultados: A partir de 1090 prontuários de pacientes/atletas atendidos, a média de idade foi 25 anos, distribuídos em 44 diferentes modalidades esportivas com predomínio do sexo masculino (75%). O tipo de lesão mais frequente foi a articular, seguida das musculares e ósseas. As lesões crônicas foram as mais frequentes (47%). O local mais lesionado foi o joelho, seguido do tornozelo e ombro. Dentre as modalidades, o futebol, o futsal e o atletismo foram as que apresentaram o maior número de atletas lesionados. Conclusão: Futebol foi a modalidade mais praticada entre os atletas atendidos, o tipo de lesão mais frequente foi o articular e o joelho foi o local mais acometido, com lesões crônicas sendo as comuns.

Massage therapy decreases pain and perceived fatigue after long-distance Ironman triathlon: a randomised trial.

QUESTION: Can massage therapy reduce pain and perceived fatigue in the quadriceps of athletes after a long-distance triathlon race (Ironman)? DESIGN: Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded outcome assessors. PARTICIPANTS: Seventy-four triathlon athletes who completed an entire Ironman triathlon race and whose main complaint was pain in the anterior portion of the thigh. INTERVENTION: The experimental group received massage to the quadriceps, which was aimed at recovery after competition, and the control group rested in sitting. OUTCOME MEASURES: The outcomes were pain and perceived fatigue, which were reported using a visual analogue scale, and pressure pain threshold at three points over the quadriceps muscle, which was assessed using digital pressure algometry. RESULTS: The experimental group had significantly lower scores than the control group on the visual analogue scale for pain (MD -7 mm, 95% CI -13 to -1) and for perceived fatigue (MD -15 mm, 95% CI -21 to -9). There were no significant between-group differences for the pressure pain threshold at any of the assessment points. CONCLUSION: Massage therapy was more effective than no intervention on the post-race recovery from pain and perceived fatigue in long-distance triathlon athletes. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-4n2sxr.

Kinesio Taping does not decrease swelling in acute, lateral ankle sprain of athletes: a randomised trial.

QUESTION: Does Kinesio Taping reduce swelling in athletes who have suffered an acute, lateral ankle sprain? DESIGN: Randomised controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment. PARTICIPANTS: Thirty-six athletes who participated regularly in one of seven different sports modalities and suffered an acute ankle sprain. INTERVENTION: The experimental group received Kinesio Taping application for 3 days, which was designed to treat swelling. The control group received an inert Kinesio Taping application. OUTCOME MEASURES: For the comparison between groups, the swelling was measured via volumetry, perimetry, relative volumetry and two analyses of the difference in volume and perimetry between ankles of each participant. Data were collected immediately after the 3 days of intervention and at follow-up, which was 15 days post intervention. RESULTS: At 3 days after intervention, there were no differences between groups for swelling in volumetry (MD -2 ml, 95% CI -28 to 32); perimetry (MD 0.2 cm, 95% CI -0.6 to 1.0); relative volumetry (MD 0.0 cm, 95% CI -0.1 to 0.1); and the other analyses. At day 15 follow-up, there were no significant between-group differences in outcomes. CONCLUSION: The application of Kinesio Taping, with the aim of stimulating the lymphatic system, is ineffective in decreasing acute swelling after an ankle sprain in athletes. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-32sctf.