Epidemiology of injuries in young volleyball athletes: a systematic review.

BACKGROUND: Volleyball is among the five most popular sports in the world. Regardless of level and age, volleyball athletes perform fast high-impact movements such as jumps, landings, and changes in direction, demanding motor and sensory skills to avoid injuries. The available scientific literature provides information regarding the incidence of injuries in volleyball, but the evidence of injuries in young volleyball athletes (12-18 years old) is not well defined. Therefore, a systematic review was conducted to investigate the incidence and prevalence of injuries in young volleyball players. METHODS: This systematic review was conducted according to the PRISMA recommendations and prospectively registered in PROSPERO (ID: CRD42022344623). An electronic search was conducted in the following databases: Web of Science, PubMed, and SportDiscuss via EBSCO in August 2022 and March 2023. Inclusion criteria followed the PICOS acronym: (P) youth volleyball players; (I) volleyball; (C) none; (O) incidence and/or prevalence of injury; and (S) cohort studies. The risk of bias was analysed using the adapted STROBE instrument. RESULTS: Five studies were included in the qualitative analysis. They had a mean methodological quality of 6 (range 4-8) on the modified STROBE scale. Injury incidence was presented in varying ways, ranging from 1.51 injuries/1000 player hours to 12.4 injuries/10,000 athlete exposures (AEs). The prevalence was 1.6 ± 1.7 per 100 AEs. A total sample of 3698 youth volleyball athletes predominantly females was found. The body sites with the highest rate of injuries were the ankle, the distal portion of the upper limbs (wrist/hand/fingers) and the knee, respectively. CONCLUSION: There was remarkable variability in the rate of injuries and the form of presentation between the studies. In addition, junior volleyball athletes had lower injury rates compared to other sports practised in high school, and older athletes had higher injury rates.

Application of shear wave elastography and B-mode ultrasound in patellar tendinopathy after extracorporeal shockwave therapy.

PURPOSE: The purpose of this study was to investigate changes in morphological and elastic properties, as estimated by B-mode ultrasound (B-US) and shear wave elastography (SWE), in volleyball athletes with patellar tendinopathy (PT) and changes after extracorporeal shockwave therapy (ESWT) as well as their relationships with US measurements and Victorian Institute of Sport Assessment-Patella (VISA-P) scores in PT. METHODS: Twelve healthy athletes (24 patellar tendons) and 31 volleyball athletes with PT (48 tendons) were included. All were examined by US and received VISA-P scores before the start of the study. The athletes received 3 months of ESWT and underwent US and VISA-P at 1 month and 3 months. VISA-P scores were used to evaluate therapeutic efficacy. Tendon thickness and cross-sectional area (CSA) were detected by B-US, and the elastic modulus was measured by SWE. Correlations between VISA-P and US measurements were calculated. RESULTS: Thickness, CSA, and elastic modulus of the patellar tendon in PT were higher than those in healthy athletes (P < 0.000). In PT with ESWT, VISA-P scores decreased by 22.1% (P < 0.000) and thickness decreased by 11.2% relative to baseline (P < 0.000). CSA decreased by 1.4% (P < 0.000). The elastic modulus decreased by 15.2% (P < 0.000). Elastic modulus, thickness, and CSA had significant negative correlations with VISA-P scores (P ≤ 0.005), with a stronger correlation between elastic modulus and VISA-P. CONCLUSION: Athletes with PT had stiffer and larger tendons than healthy athletes. SWE combined with B-US could clearly show the changes in tendon thickness, CSA, stiffness in PT, and changes after treatment. SWE combined with B-US provided visualization with quantitative, reproducible, and noninvasive imaging in the follow-up evaluation of PT and is worth promoting clinically.

Lesiones en el voley de alto rendimiento / Volleyball injuries in high-performance athletes

El vóley es un deporte popular con aproximadamente dos millones de profesionales en el mundo, clásicamente se describe como una práctica con bajos índices de lesiones. El nivel profesional hace que muchos deportistas convivan con dolor y esta adaptación podría influir en la incidencia de lesiones. En el siguiente trabajo intentamos realizar una descripción de las lesiones evaluadas en la selección mayor de vóley masculina. Se realizó un seguimiento desde 2014 hasta 2016. Se evaluaron 78 deportistas, con 37 lesiones, en 21.812 horas de exposición. Los resultados fueron: 1,69 LESIONES CADA MIL HORAS. Con predominio de las lesiones musculares. El índice de lesiones durante los partidos fue mayor que el de los entrenamientos. En el seguimiento anual detectamos un marcado descenso de las lesiones musculares en 2016. Comparando nuestra experiencia con los reportes mundiales encontramos diferencias en las frecuencias de los diagnósticos. Nuestros reportes muestran a las alteraciones musculares como principal causa de lesión contrastando, con lo reportado en otros trabajos donde fueron los esguinces. En nuestra opinión esto podría obedecer a los trabajos de prevención que se realizan desde las categorías juveniles. En conclusión, nuestros índices de lesión son similares a los reportados internacionalmente pero varían en el tipo de lesión. Queremos remarcar la importancia en documentar la evolución de las patologías para tener un estrecho seguimiento de las mismas y adoptar medidas de cambio a tiempo

Volleyball is a popular sport with approximately two million professionals worldwide, classically described as a practice with low injury rates. The professional level causes many athletes to live with pain and this adaptation could influence the incidence of injuries. In the next paper we try to make a description of the injuries evaluated in the major selection of male volleyball. Follow-up was made from 2014 to 2016. 78 athletes, with 37 injuries, were evaluated at 21,812 hours of exposure. The results were: 1.69 INJURY EVERY THOUSAND HOURS. Predominantly with muscle injuries. The injury rate during the matches was May than that of the training. In the annual follow-up we detected a marked decrease in muscle injuries in 2016. Comparing our experience with global reports we find differences in diagnostic frequencies. Our reports show muscle disturbances as the main cause of injury contrasting with reports by other authors where the sprains were. In our opinion this could be due to the prevention work carried out from he youth categories. In conclusion our injury rates are similar to those reported internationally but vary in the type of injury. We want to emphasize the importance in documenting the evolution of pathologies in order to closely monitor them and take measures in time

Partial Hemiresurfacing of Osteochondral Defects of the Talus? Surgical Technique and Preliminary Report from Four Patients.

BACKGROUND: Osteochondral lesions of the medial talus (OLT) frequently lead to chronic ankle pain and osteoarthritis. Arthroscopic debridement, subchondral bone stimulation by drilling, and microfracturing are options for primary therapy in small lesions. In larger lesions, restoration of the talar dome contour seems to be a mandatory course of action. METHODS: In a case series, we followed up four patients being treated with a focal resurfacing prosthetic due to large osteochondral talar lesions. In contrast to other studies, we can report on an off-label application to restore defects of the lateral talar dome with two patients for the first time. At follow-up, three patients reported a remarkable reduction in pain and were able to return to sports activities. One patient developed pseudarthrosis of the medial malleolar osteosynthesis. CONCLUSIONS: With selected patients, focal resurfacing appears to be an option for large osteochondral defects of the talus.

Anterior cruciate ligament injury profile in Italian Serie A1-A2 women's volleyball league.

BACKGROUND: The aim of this study was to assess how anterior cruciate ligament (ACL) ruptures with subsequent surgery reconstruction impact on the professional career of A1-A2 Italian women's volleyball league players. METHODS: Using an observational study with a retrospective case-series design for ACL ruptures, 125 teams with 1488 players were monitored. Subjects had to report level, role, injury modality, lower limb injured, laterality, period of the season and age. RESULTS: A total of 34 ACL ruptures were reported. Thirty-three (97%) were non-contact and 1 (3%) with contact. Twenty-one (61.7%) occurred in landing from a jump attack, 3 (8.8%) in landing from wall jump, 1 (3%) with apparent contact and 9 (26.5%) in other landing conditions. The most injured knee was the left limb (22, 64.7%) respect to the right limb (12, 35.3%). Fourteen (41.2%) ruptures occurred in spikers, 10 (29.4%) in middle blockers, 6 (17.6%) in setters, 3 (8.8%) in liberos and 1 (3%) in opposite hitters. Nine (26.5%) occurred in pre-season period, 16 (47%) in the first round, 4 (11.8%) in the second round, and 5 (14.7%) during play-off. The average age of the first ACL rupture was 23±3 years. CONCLUSIONS: We observed that female volleyball players of A1-A2 Italian volleyball league occurred mostly in a left non-contact ACL rupture during a landing condition and the spikers were the players most at risk. Therefore, it is desirable that coaches teach players variations of landing in order to avoid possible chronic overloading of ACL.

Desgarro del recto abdominal en jugadores de selección nacional masculina de voleibol. Serie de casos y revisión de la bibliografía / Rectus abdominis muscle strain in team selection male volleyball players. Case series and bibliographic review

Introducción: El recto abdominal (RA), es un musculo par, acintado, que tiene como principales funciones la flexión del tronco y la estabilidad del Core. Su desgarro se asocia al deporte de elite y lanzadores, mayormente vinculado con el tenis y su servicio según publicaciones. En voleibol se repiten ciclos de hiperextensión del tronco con sobrecarga excéntrica y consecuente hipertrofia asimétrica del RA contralateral al brazo dominante, asiento de la lesión muscular. Materiales y métodos: Se realizó un estudio descriptivo, retrospectivo de una serie de motivos de consulta de jugadores de la Selección Nacional Argentina masculina mayor de voleibol durante el período comprendido entre 2015 y 2017. Se clasificaron las lesiones en función del retorno al deporte según Paús V. y Torrengo. Los deportistas con desgarro de RA, fueron agrupados evaluando las variables: brazo dominante, RA lesionado, tipo de lesión muscular, gesto deportivo involucrado, situación de competencia durante la lesión, lesión abdominal previa. Resultados: Se evaluaron 386 motivos de consulta, los jugadores centrales fueron los que más consultaron, en el contexto general de lesiones se clasificaron los 10 motivos principales de consulta, las lesiones musculares funcionales (contracturas) fueron las más frecuentes (n97, 25%), el desgarro de RA fue la lesión muscular estructural predominante por encima del gastrocnemio. 6 casos de lesión aguda y 1 caso de recurrencia, la mayoría durante el gesto de ataque y en competencia. Conclusión: De lo analizado en los registros la lesión muscular representó el 42% del total de las lesiones, el desgarro tiene predominio en el recto abdominal representando el 32% de total de las lesiones musculares estructurales. Nivel de evidencia: IV

Introduction: The rectus abdominis (RA), is a pair, curved muscle, whose main functions are trunk flexion and Core stability. His strain is associated with the sport of elite and pitchers, mostly linked to tennis and its service according to publications. In volleyball, cycles of hyperextension of the trunk with eccentric sebrecharge and consequent asymmetric hypertrophy of the RA contralateral to the dominant arm, seat of the muscle injury, are repeated. Materials and methods: A descriptive, retrospective study of a series of reasons for consultation of players of the Argentine National Men's Volleyball Team during the period between 2015 and 2017 was carried out. The injuries were classified according to the return to sport criteria by Páus V. and Torrengo F. The athletes with RA strain were grouped evaluating following variables: Dominant arm, injured RA, type of muscle injury, sports gesture involved, competition situation at injury time, previous abdominal lesion. Results: We evaluated 386 reasons for consultation, the central players were the most consulted, in the general context of injuries were classified the 10 main reasons for consultation, muscle functional injuries (contractures) were the most frequent (n97, 25%), the RA strain was the predominant structural muscle lesion above the gastrocnemius. 6 case of acute injury and 1 case of recurrence. most during the attack gesture and in competition. Conclusion: From the analyzed in the registers the muscular injury represented 42% of the total of the injuries, the strain has predominance in the rectus abdominus representing 32% of the total of the muscular structural injuries. Level of evidence: IV

Vascular Quadrilateral Space Syndrome in 3 Overhead Throwing Athletes: An Underdiagnosed Cause of Digital Ischemia.

Vascular quadrilateral space syndrome (vQSS) is an underdiagnosed cause of extremity ischemia, pain, and paresthesia in overhand throwing athletes. The mechanism of vQSS is thought to result from repeated abduction and external rotation of the arm leading to a distraction injury of the posterior circumflex humoral artery (PCHA) as this courses through the quadrilateral space. This trauma may cause dissection and dissecting aneurysm formation. Thrombus from this arterial injury then embolizes down the arm resulting in the symptomatic presentation. Patients were often presented after multiple embolic events, which have resulted in obliteration of digital arteries. Later stages of presentation may include ischemic ulceration and gangrene. We report 3 cases of vQSS in overhand throwing athletes. All 3 underwent surgical correction and have returned to competition. We discuss presentation, diagnosis, imaging findings, management, outcomes, and review of the literature. Prompt recognition of this syndrome is essential to optimal treatment, which includes PCHA ligation and division with or without thrombolytic therapy. Increased awareness of vQSS is needed among coaches and athletic trainers who often identify the symptoms and initiate the treatment. When treated promptly, these athletes return to baseline functional status.

Effects of scapular taping on the activity onset of scapular muscles and the scapular kinematics in volleyball players with rotator cuff tendinopathy.

OBJECTIVES: To examine the effect of scapular taping on the activity onset of scapular muscles and the scapular kinematics during arm elevation in volleyball players with rotator cuff (RC) tendinopathy. DESIGN: Randomized placebo-controlled repeated measures METHODS: Twenty-six male volleyball players with RC tendinopathy (mean age=23.6±3.3years) participated in the study. Electromyography (EMG) activity onset of upper trapezius (UT), middle trapezius (MT), lower trapezius (LT) and serratus anterior (SA) and the three-dimensional scapular kinematics quantified by using an acromial marker cluster method were compared with three scapular taping protocols, namely, no taping, therapeutic taping, and placebo taping. RESULTS: The MT, LT and SA activated significantly earlier in both therapeutic taping (all p<0.005) and placebo taping conditions than no taping conditions (all p<0.002). There was a small increase in the scapular upward rotation when therapeutic taping and no taping conditions were compared (p=0.007). CONCLUSIONS: Scapular taping may enhance the neuromotor control of the scapular muscles. Whether it provides adequate support for normal scapular kinematics during arm movement in athletes with RC tendinopathy await for further studies.

Scapholunate interosseous ligament injury in professional volleyball players.

Injuries to the scapholunate interosseous ligament (SLIL) are the most common cause of carpal instability. A SLIL injury typically follows a fall on an outstretched hand, with the wrist in hyperextension, ulnar deviation and intercarpal supination. We hypothesize that repetitive axial loading on the wrist in hyperextension, during the reception and digging motions of volleyball, can lead to functional overloading of the SLIL. To identify patients and to determine the clinical history and surgical treatment performed, we analyzed hospital records, X-rays, electronic databases containing all the operations performed, and image files (including before and after surgery and follow-up). We identified three SLIL injury cases in national volleyball team players, also at the libero position, who were treated at our clinic between 2007 and 2013 for scapholunate instability. Open reduction and Berger capsulodesis was performed in all cases. At a mean follow-up of 3 years (range, 22-50 months), the mean pain level on VAS was 0.3 (range, 0-1) at rest and 1.7 (range 1-2) during sport activities. The mean DASH score was 4 (range 2-5). The mean wrist flexion was 60° (range 55-70°) and extension was 80° (range 75-85°). Given the greater susceptibility of these players for developing a SLIL injury, a high index of suspicion is needed when managing athletes presenting with wrist pain or instability.

Thoracic Outlet Syndrome in a Volleyball Player Due to Nonunion of the First Rib Fracture.

Fracture of the first rib with ensuing callus formation is a rare cause of thoracic outlet syndrome. We report a case of a 17-year-old female volleyball player who presented with months of chronic arm pain. Radiographic imaging demonstrated nonunion fracture of the first rib. Physical therapy had been unsuccessful in relieving the pain, and surgical management was performed with resection of the first rib through a transaxillary approach with complete resolution of symptoms. Inflammation surrounding such fractures may destroy tissue planes, making dissection more technically difficult.

Dorsal Radiotriquetral Ligament Snapping Wrist Syndrome - A Novel Presentation and Review of Literature: Case Report.

We report 2 cases of audible intrinsic wrist snapping without a palpable click resulting from dorsal radiotriquetral ligament adhesions. After its debridement, both patients demonstrated complete resolution of symptoms.

Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes.

BACKGROUND: Anterior tibial stress fractures are associated with high rates of delayed union and nonunion, which can be particularly devastating to a professional athlete who requires rapid return to competition. Current surgical treatment strategies include intramedullary nailing, which has satisfactory rates of fracture union but an associated risk of anterior knee pain. Anterior tension band plating is a biomechanically sound alternative treatment for these fractures. HYPOTHESIS: Tension band plating of chronic anterior tibial stress fractures leads to rapid healing and return to physical activity and avoids the anterior knee pain associated with intramedullary nailing. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between 2001 and 2013, there were 13 chronic anterior tibial stress fractures in 12 professional or collegiate athletes who underwent tension band plating after failing nonoperative management. Patient charts were retrospectively reviewed for demographics, injury history, and surgical details. Radiographs were used to assess time to osseous union. Follow-up notes and phone interviews were used to determine follow-up time, return to training time, and whether the patient was able to return to competition. RESULTS: Cases included 13 stress fractures in 12 patients (9 females, 3 males). Five patients were track-and-field athletes, 4 patients played basketball, 2 patients played volleyball, and 1 was a ballet dancer. Five patients were Division I collegiate athletes and 7 were professional or Olympic athletes. Average age at time of surgery was 23.6 years (range, 20-32 years). Osseous union occurred on average at 9.6 weeks (range, 5.3-16.9 weeks) after surgery. Patients returned to training on average at 11.1 weeks (range, 5.7-20 weeks). Ninety-two percent (12/13) eventually returned to preinjury competition levels. Thirty-eight percent (5/13) underwent removal of hardware for plate prominence. There was no incidence of infection or nonunion. CONCLUSION: Anterior tension band plating for chronic tibial stress fractures provides a reliable alternative to intramedullary nailing with excellent results. Compression plating avoids the anterior knee pain associated with intramedullary nailing but may result in symptomatic hardware requiring subsequent removal.

Ultrasonographic evaluation of the shoulder in elite Italian beach volleyball players.

AIM: Beach volleyball is an overhead sport that subjects the hitting shoulder to intense functional loads. The purpose of this study is to identify ultrasonographically the prevalence of myotendinous alterations in professional Italian beach volleyball players at the Italian championship and to look for associations between ultrasound findings and the other data collected. METHODS: Fifty-three beach volleyball players (31 women, 22 men) were recruited during the second stage of the Italian championship held in July 2012 in Rome, Italy. Clinical history was obtained from all subjects, followed by physical exam. Each athlete completed a questionnaire regarding sports activities. Bilateral ultrasonographic evaluation of the shoulders was then performed. RESULTS: Calcific tendinopathy of the rotator cuff of the hitting shoulder was identified ultrasonographically in 30% of the athletes. The mean age of the athletes with calcific tendinopathy was older than subjects with other abnormalities on ultrasonographic examination (33.1 years vs. 25.8 years, t-test; P<0.0001). Impingement was recognized ultrasonographically in the hitting shoulder in 10 of the athletes (18.8%). The Neer's test was positive in the cases of anterior impingement (χ2; P<0.002). CONCLUSION: Calcific tendinopathy of the rotator cuff of the hitting shoulder in professional beach volleyball players has a prevalence of 30% ultrasonographically, greater than that reported in the general population. In these athletes, the presence of calcific tendinopathy correlates positively with age.

Bilateral medial patellofemoral ligament reconstruction in high-level athletes.

This report presents two cases of high-level athletes with bilateral patellar dislocations who were able to return to their preinjury level of activity after bilateral medial patellofemoral ligament (MPFL) reconstruction, without any major complications. Patient 1 was a 19-year-old male volleyball player for a top-level college volleyball team, and patient 2 was a 24-year-old woman who was a member of a national-level adult softball team. MPFL reconstruction could be an effective treatment for bilateral patellar dislocation in high-level athletes. Level of evidence V.

Recurrent anterior instability of the radial head: case report.

We present a case of recurrent anterior instability of the radial head presenting 4 weeks after injury. A 16-year-old girl injured the right upper extremity while playing volleyball. Thereafter, she felt a recurrent click associated with pain in the elbow when rotating the forearm. Image intensifier findings implied that the radial head would anteriorly dislocate with contraction of the biceps brachii. Annular ligament reconstruction using the palmaris longus tendon graft relieved the instability.

Prevalência de subluxações cervicais e torácicas com relação ao membro dominante superior em atletas amadores de voleibol / Prevalence of cervical and thoracic subluxations in relation to the dominant upper limb in amateur volleyball players

O voleibol exige um ótimo condicionamento físico, força, velocidade, agilidade e flexibilidade de seus participantes. Nele, a repetição de determinados tipos de movimentos e a sobrecarga de treinamento exigida produz um processo de adaptação orgânica do corpo que resulta, muitas vezes, em desequilíbrio muscular. Somado a isso, os gestos específicos e os erros na técnica de execução dos movimentos podem aumentar a prevalência de alterações posturais influenciando o aumento de possibilidades de lesões (JUNIOR, 2004). As alterações posturais, por sua vez, podem ocasionar distúrbios que afetam a coluna vertebral. Objetivo: o propósito do estudo foi detectar as principais subluxações - vertebrais cervicais e torácicas - por meio da análise das rotações do processo espinhoso de cada vértebra e lateralidade do atlas com o membro dominante superior, relacionando com as categorias e com a posição em quadra de atletas de Voleibol. Método: para tanto, realizou-se uma pesquisa descritiva com 145 atletas de categorias de base e adulta que treinam mais de dois dias por semana. Os atletas foram submetidos a uma avaliação quiroprática. Resultados e Discussão: verificou-se que as subluxações mais prevalentes foram das vértebras C1, C7, T4, T8 e T12. Observou-se que a musculatura e a articulação do ombro estão diretamente interligadas com as subluxações encontradas. Atletas ambidestros apresentaram menor percentagem de subluxações e maior equilíbrio rotacional dos processos espinhosos e da lateralidade do atlas. Os demais atletas apresentaram a lateralidade do atlas e as rotações do processo espinhoso das regiões cervical e torácica para o lado direito...

Volleyball requires a great physical fitness, strength, speed, agility and flexibility of its players. In it, the repetition of certain types of movements and the overload of training required may produces an organic process of adaptation of the body that often results in muscle imbalance. Added to this, the specific gestures and errors in technique of the movements may increase the prevalence of postural changes influencing the increased possibilities of injuries. Postural changes, inturn, can lead to disorders affecting the spine. Objective: the purpose of the study was to identify the main subluxations - cervical and thoracic - through the analysis of rotations of the spinous process of each vertebra and laterality of the atlas with the dominant upper limb, in what respect the categories and the position in court of volleyball athletes. Method: it was carried out a descriptive study of 145 athletes from youth teams and adult training more than two days per week. The athletes underwent a chiropractic evaluation. Results and Discussion: it was found that the most prevalent vertebral subluxation are C1, C7, T4, T8 and T12. It was noted that the muscles and the shoulder joint are directly interconnected with the subluxations found. Ambidextrous athletes showed lower percentage of subluxations and higher rotational equilibrium of the spinous processes and the laterality of the atlas. The other athletes showed the laterality of the atlas and the rotations of the spinous process of the cervical and thoracic regions to the right side...

Balance error scoring system performance changes after a competitive athletic season.

OBJECTIVE: To evaluate the change in Balance Error Scoring System (BESS) performance after an athletic season. DESIGN: A prospective longitudinal group study. SETTING: University biomechanics research laboratory. PARTICIPANTS: A total of 58 college-aged females (23 soccer student-athletes, 16 volleyball student-athletes, and 19 recreationally active healthy college students) participated in the study. INTERVENTIONS: The BESS test was administered on 2 occasions 90 days apart. For the student-athletes, the first test (PRE) was administered before the start of their athletic season and the second test (POST) was administered immediately after the season. For the recreationally active college students, the PRE test was at the beginning of the academic semester and the POST test exactly 90 days thereafter. MAIN OUTCOME MEASURES: Total BESS score at PRE and POST was compared with a 3 × 2 repeated measures analysis of variance. The overall change score and absolute value change score were also calculated and compared with a 1-sample t test to an expected change of zero errors. RESULTS: There was no group by time interaction; however, there was a main effect for time. There was a significant improvement (P = 0.003) between PRE (9.00 ± 2.97 errors) and POST (7.92 ± 2.78 errors) BESS performance. There were significant differences for both the overall change score (1.08 errors) and the absolute value change score (2.00 errors). CONCLUSIONS: A clinically and statistically significant difference in BESS performance was identified after a 90-day intercollegiate athletic season.

Premature cystic lesions in shoulders of elite junior javelin and volleyball athletes: a comparative evaluation using 3.0 Tesla MRI.

BACKGROUND: The purpose of this study was to evaluate clinical and magnetic resonance imaging (MRI) findings in the shoulders of high performance competitive junior javelin athletes and volleyball players. The hypothesis was that structural lesions already exist in young and asymptomatic overhead athletes. METHODS: Thirty-one healthy high performance junior elite athletes were included. Group 1 consisted of 15 male javelin throwers (mean age, 17.7 ± 0.8 years) and group 2 of 16 male volleyball players (16.9 ± 1.0 years). Questionnaire-based interviews, comprehensive clinical examination, and shoulder scoring systems (visual analog scale [VAS] and Constant-Murley Score) were completed. Bilateral shoulder imaging was performed using a 3.0 Tesla MRI. RESULTS: The Constant-Murley Score of group 1 was 95.5 ± 3.6 and 94.7 ± 4.6 points for group 2. Group 1 demonstrated a mean VAS of 0.9 ± 1.6 and group 2 a mean of 0.6 ± 0.8 points. Postero-superior intraosseous cysts of the humeral head were detected in 73.3% of all javelin throwers in the dominant shoulder, but only in 13.3% in the nondominant shoulder (P = .008). In the volleyball group, such cyst formation was rarely seen in 12.5% in the dominant versus 6.3% in the nondominant shoulder (P = .66). CONCLUSION: A high percentage of junior elite athletes already demonstrate osseus signs of overloading especially in the group of javelin athletes, although none had a history of prior shoulder pathology. Therefore, junior overhead athletes might be at risk for the early development of structural lesions at the insertion of the posterior rotator cuff similar to lesions already known for adult athletes, even though they do not present clinical signs of overuse at that age.

Use of facial protection to prevent reinjury during sports practice.

The objective of the study was to report the prevention of facial reinjury of a volleyball player using a custom-made protective facial shield. A custom-made protective partial facial shield was fabricated using polymethylmethacrylate and was fitted with a soft lining material to provide additional comfort and protection to the injured area. Facial protection provides greater security against possible facial injuries and allows injured areas to recover during sports practice.