Effects of the open Latarjet procedure on shoulder kinematics and periscapular muscle activity three months postoperatively.

BACKGROUND: The debate surrounding the influence of the open Latarjet procedure on postoperative scapular motions persists, and there is no evidence regarding its effects on periscapular muscle activation. This study aimed to assess the short-term influence of open Latarjet procedure on scapular kinematics and periscapular muscle activity during arm raising and lowering based on comparisons between patient and healthy athletes. METHODS: 22 healthy male athletes and 22 male athletes scheduled for glenohumeral stabilization surgery by open Latarjet procedure were included. Scapular kinematics, periscapular muscle activities and shoulder-related quality of life were recorded prior to surgery and 3 months postoperatively for the Latarjet group. For the healthy group, same assessments were performed 3 months apart. Bilateral differences in both scapular kinematics and periscapular muscle activation ratios, and Western Ontario Shoulder Instability (WOSI) index were defined as dependent variables. RESULTS: Scapular kinematics of the operated shoulder, namely scapular upward/downward rotation, internal/external rotation and anterior/posterior tilt recorded between 20° and 120° of humerothoracic elevation, showed no alterations 3 months post-surgery (p>0.05), and did not differ from those observed in healthy athletes (p>0.05). Similarly, all periscapular muscle activations were not different within time and between groups (p>0.05). WOSI index of the operated shoulder was significantly improved postoperatively (871.9 ± 443.7 vs. 1346.3 ± 552.3) but remained higher than the WOSI indices of the non-operated shoulder or those of the healthy group (52.7±75.6). CONCLUSION: This study emphasizes the short-term effects of the open Latarjet procedure, demonstrating an improvement in the shoulder-related quality of life 3 months after surgery. Notably, during this period, both kinematics and periscapular muscle activity remained consistent, and similar to the patterns observed for healthy athletes.

Effects of Repeated High-Intensity Effort Training or Repeated Sprint Training on Repeated High-Intensity Effort Ability and In-Game Performance in Professional Rugby Union Players.

ABSTRACT: Glaise, P, Rogowski, I, and Martin, C. Effects of repeated high-intensity effort training or repeated sprint training on repeated high-intensity effort ability and in-game performance in professional rugby union players. J Strength Cond Res 38(5): 932-940, 2024-This study investigated the effects of repeated high-intensity efforts (RHIE) training compared with repeated sprint exercise (RSE) training on RHIE ability (RHIEa) and in-game performance in professional rugby union players. Thirty-nine, male, professional, rugby union players were randomly assigned to 3 training groups (RHIE training, RSE training, and control). Repeated high-intensity effort ability and high-intensity effort characteristics (including sprints, acceleration, and contact efforts) during official games were measured before and after a 10-week specific (RHIE, RSE, or control) training period. The results of this study showed that concerning RHIEa, both the RHIE and RSE training significantly increased the players' average sprint velocity ( p < 0.001, d = -0.39 and p < 0.001, d = -0.53 respectively), average sled push velocity (ASPV; p < 0.001, d = -0.81 and p = 0.017, d = -0.48 respectively), and RHIE score ( p < 0.001, d = -0.72 and p < 0.001, d = -0.60 respectively). Repeated high-intensity effort training trended in a smaller increase in average sprint velocity than RSE training, a larger increase in ASPV, and a similar increase in RHIE score. Concerning in-game high-intensity efforts, both the RHIE and RSE training produced significant improvements in the number of sprints ( p = 0.047, d = -0.28 and p < 0.001, d = -0.47 respectively), total distance ( p < 0.001, d = -0.50 and p = 0.002, d = -0.38 respectively), the number of accelerations ( p < 0.001, d = -0.37 and p = 0.003, d = -0.32 respectively), and contact rate ( p < 0.001, d = -0.97 and p = 0.020, d = -0.28 respectively). Conversely, the magnitude of the increase in contact rate was almost twice as high in RHIE compared with RSE training. To conclude, the findings of this study were that both RSE and RHIE training are effective methods for developing RHIEa and in-game high-intensity efforts in professional rugby union. In practical applications, as the gains in certain abilities and game performance data differed depending on the training method chosen, we suggest that coaches choose the most appropriate method according to the profile of the players, their position, and the style of play they want to develop.

Sling-based Exercise for External Rotator Muscles: Effects on Shoulder Profile in Young Recreational Tennis Players

Context: Tennis playing generates specific adaptations, particularly at the dominant shoulder. It remains to be established whether shoulder strength balance can be restored by sling-based training for adolescent recreational tennis players. Objective: We added a sling-based exercise for shoulder external rotators to investigate its effects on external rotator muscle strength, on internal rotator muscle strength, on glenohumeral range of motion and on tennis serve performance. Design: Test-retest design. Setting: Tennis training sports facilities. Participants: Twelve adolescent male players volunteered to participate in this study (age: 13.3 ± 0.5 years; height: 1.64 ± 0.07 cm, mass: 51.7 ± 5.8 kg, International Tennis Number: 8). Intervention: The procedure spanned 10 weeks. For the first five weeks, players performed their regular training (RT) twice a week. For the last five weeks, a sling-based exercise (SE) for strengthening the shoulder external rotator muscles was added to their regular training. Main Outcome Measures: Maximal isometric strength of shoulder external and internal rotator muscles and glenohumeral range of motion in external and internal rotation were assessed in both shoulders. Serve performance was also evaluated by accuracy and post-impact ball velocity, using a radar gun. Results: No change was found in any measurement after the RT period. Significant increases in external (~+5%; p<0.001) and internal (~+2%; p<0.05) rotator muscle strength and in external/internal strength ratio (~+4%; p<0.001) were observed after the SE period. Serve velocity and accuracy were significantly improved after SE (~+2% and ~+24%, respectively; p<0.05 for both), while no clinically meaningful alterations in ranges of motion were observed. Conclusions: Prophylactic intervention through sling-based exercise for strengthening shoulder external rotator muscles appears effective in restoring strength balance at the dominant shoulder, and may prevent adolescent tennis players from sustaining degenerative shoulder problems which could later impair their performance of daily and work-related tasks.

Effects of Self-Myofascial Release on Shoulder Function and Perception in Adolescent Tennis Players.

CONTEXT: Tennis induces a decreased internal rotation range of motion at the dominant glenohumeral joint. The effects of self-myofascial release have not yet been investigated to restore glenohumeral range of motion. OBJECTIVE: This study aimed at investigating the effects of self-myofascial release on shoulder function and perception in adolescent tennis players. DESIGN: Test-retest design. SETTING: Tennis training sport facilities. PARTICIPANTS: Eleven male players participated in this study (age: 15 [3] y; height: 173.1 [11.1] cm; mass: 56.0 [15.1] kg; International Tennis Number: 3). INTERVENTION: During 5 weeks, the players performed their regular tennis training. During 5 additional weeks, self-myofascial release of the infraspinatus and pectoralis muscles was implemented 3 times per week after the warm-up of the regular training session. MAIN OUTCOME MEASURES: The primary outcome was glenohumeral internal rotation range of motion. The secondary outcomes were perceived shoulder instability and tennis serve accuracy and velocity. RESULTS: Adding self-myofascial release allowed an increase of 11° (2°) of internal rotation range of motion at the dominant glenohumeral joint (P < .001) and a decreased perception of shoulder instability (P = .03), while maintaining tennis serve velocity and accuracy. CONCLUSIONS: Implementing self-myofascial release on infraspinatus and pectoralis muscles 3 times per week during 5 weeks improved dominant glenohumeral internal rotation range of motion in tennis players. It can be used as a strategy to preserve the mobility of this joint.

Performance factors related to the different tennis backhand groundstrokes: a review.

The backhand is one of the two basic groundstrokes in tennis and can be played both with one or two hands, with topspin or backspin. Despite its variety of derivatives, the scientific literature describing the backhand groundstroke production has not been reviewed as extensively as with the serve and the forehand. The purpose of this article is to review the research describing the mechanics of one and two-handed backhands, with a critical focus on its application to clinicians and coaches. One hundred and thirty four articles satisfied a key word search (tennis, backhand) in relevant databases and manual search, with only 61 of those articles considered directly relevant to our review. The consensus of this research supports major differences between both the one- and two-handed strokes, chiefly about their respective contributions of trunk rotation and the role of the non-dominant upper extremity. Two-handed backhand strokes rely more on trunk rotation for the generation of racquet velocity, while the one-handed backhands utilize segmental rotations of the upper limb to develop comparable racquet speeds. There remains considerable scope for future research to examine expertise, age and/or gender-related kinematic differences to strengthen the practitioner's understanding of the key mechanical considerations that may shape the development of proficient backhand strokes. Key pointsOne-and two-handed backhands require different motor coordinationTwo-handed backhand strokes rely more on trunk rotation for racquet velocity generation, whereas one-handed backhand strokes rely more on segmental rotations of the upper limbPlayers using a two-handed backhand should learn early a slice one-handed backhand because of the different co-ordination pattern involvedEquipment scaling is a great tool for coaches to learn early proper one-handed backhand strokesFuture research related to the interaction between backhand technique, gender and skill level is needed.

Scapulothoracic kinematics during tennis forehand drive.

Scapular dyskinesis is recognized as an abnormality in the kinetic chain; yet, there has been little research quantifying scapular motion during sport tasks. Tennis forehand drives of eight highly skilled tennis players were studied to assess the scapulothoracic kinematics and evaluate repeatability using video-based motion analysis. Scapulothoracic downward/upward rotation, posterior/anterior tilt, and internal/external rotation were computed using an acromial marker cluster. On average, the upward rotation, anterior tilt, and internal rotation varied from 1 degrees to 26 degrees, from 7 degrees to 32 degrees, and from 42 degrees to 100 degrees, respectively, during the tennis forehand drive. During the backswing and forward swing phases of the forehand stroke, small changes were observed for the three scapular angle values, while all angles increased rapidly during the follow-through phase. This suggests that the tennis forehand drive may contribute to scapula dyskinesis, mainly due to the great amplitude in scapulothoracic anterior tilt and internal rotation observed during the follow-through phase. Knowledge of normal scapula motion during sport tasks performed at high velocity could improve the understanding of various sport-specific adaptations and pathologies.

Effects of 6-week sling-based training of the external-rotator muscles on the shoulder profile in elite female high school handball players.

CONTEXT: In women's handball, the large numbers of throws and passes make the shoulder region vulnerable to overuse injuries. Repetitive throwing motions generate imbalance between shoulder internal- and external-rotator muscles. It has not yet been established whether sling-based training can improve shoulder external-rotator muscle strength. OBJECTIVE: This study investigated the effectiveness of a 6-wk strengthening program in improving shoulder functional profile in elite female high school handball players. DESIGN: Crossover study. SETTING: National elite handball training center. PARTICIPANTS: 25 elite female high school handball players. INTERVENTIONS: The program, completed twice per week for 6 wk, included sling-based strengthening exercises using a suspension trainer for external rotation with scapular retraction and scapular retraction alone. MAIN OUTCOMES: Maximal shoulder external- and internal-rotation strength, shoulder external- and internal-rotation range of motion (ROM), and maximal throwing velocity were assessed preintervention and postintervention for dominant and nondominant sides. RESULTS: After sling training, external- and internal-rotation strength increased significantly for both sides (P ≤ .001, and P = .004, respectively), with the result that there was no significant change in external- and internal-rotation strength ratios for either the dominant or the nondominant shoulder. No significant differences were observed for external-rotation ROM, while internal-rotation ROM decreased moderately, in particular in the dominant shoulder (P = .005). Maximal throwing velocity remained constant for the dominant arm, whereas a significant increase was found for the nondominant arm (P = .017). CONCLUSIONS: This 6-wk strengthening program was effective in improving shoulder external-rotator muscle strength but resulted in a decrease in the ROM in shoulder internal rotation, while throwing velocity remained stable. Adding a stretching program to this type of sling-based training program might help avoid potential detrimental effects on shoulder ROM.

Reliability of EMG normalisation methods for upper-limb muscles.

The study investigated different electromyographic (EMG) normalisation methods for upper-limb muscles. This assessment aimed at comparing the EMG amplitude and the reliability of EMG values obtained with each method. Eighteen male tennis players completed isometric maximal voluntary contractions and dynamic strength exercises (push-ups and chin-ups) on three separate test sessions over at least 7 days. Surface EMG activity of nine upper body muscles was recorded. For each muscle, an analysis of variance for repeated measures was used to compare maximal EMG amplitudes between test conditions. The intra-class correlation coefficient, the coefficient of variation and the standard error of measurement were calculated to determine the EMG reliability of each condition. On the basis of a compromise between maximal EMG amplitude and high reliability, the chin-ups appeared to be the optimal normalisation method for M. latissimus dorsi, M. posterior deltoid, M. biceps brachii, M. flexor carpi radialis and M. extensor carpi radialis. The push-ups seemed relevant to normalise M. anterior deltoid and M. triceps brachii activity, while isometric maximal voluntary contraction remained the most appropriate method for M. pectoralis major and M. middle deltoid. Thus, original methods are proposed to normalise EMG signal of upper-limb muscles.

Effects of two training protocols on the forehand drive performance in tennis.

The aim of this study was to examine the effects of 2 training modalities on the tennis forehand drive performance. Forty-four tennis players (mean ± SD: age = 26.9 ± 7.5 years; height = 178.6 ± 6.7 cm; mass = 72.5 ± 8.0 kg; International Tennis Number = 3) were randomly assigned into 3 groups. During 6 weeks, the first group performed handled medicine ball (HMB) throws included in the regular tennis practice, the second group (overweight racket-OWR) played tennis forehand drives with an overweighed racket during the regular tennis practice, and the third group (regular tennis training-RTT) practiced only tennis training as usual. Before and after the 6-week program, velocity and accuracy of tennis crosscourt forehand drives were evaluated in the 3 groups. The main results showed that after 6-week training, the maximal ball velocity was significantly increased in HMB and OWR groups in comparison with RTT (p < 0.001 and p = 0. 001, respectively). The estimated averaged increase in ball velocity was greater in HMB than in OWR (11 vs. 5%, respectively; p = 0.017), but shot accuracy tended to be deteriorated in HMB when compared with OWR and RTT (p = 0.043 and p = 0.027, respectively). The findings of this study highlighted the efficiency of both training modalities to improve tennis forehand drive performance but also suggested that the HMB throws may be incorporated into the preseason program preferably, whereas the OWR forehand drives may be included in the on-season program.

Physical outcome in a successful Italian Serie A soccer team over three consecutive seasons.

The aim of this study was to examine the physical performance of a successful Italian Serie A team of more than 3 consecutive seasons. Twenty-five players participated in the study and were classified into 3 playing positions: defenders (n = 9), midfielders (n = 11), and forwards (n = 5). Activities match were studied by an analysis of multiple match camera SICS throughout the competition Italian Serie A matches played at home (n = 90) for 3 consecutive seasons (first: 2004/2005; second: 2005/2006; and third: 2006/2007). Total team ball possession and time-motion characteristics were examined. Results showed that total ball possession (52.1-54.9%) and the number of points accumulated at home (40/48) improved in the past 3 seasons, whereas the final rankings at home were stable. The total distances covered by minutes of play were significantly different between the 3 seasons (118.32 ± 6.69 m·min to 111.96 ± 8.05 m·min). Distance running and high-intensity activities were similar in the 3 seasons, whereas the distance covered in moderate-intensity running decreased in the third (p < 0.05). Variations between playing positions were found during the 3 consecutive seasons, with midfielders covering greater distances than defenders (p < 0.05) and forwards (p < 0.01). This study showed how for 3 consecutive seasons a Serie A team of successful players reduced their distances performed at submaximal speeds, and increased ball possession, while maintaining the high-intensity activities and the number of points at home. It is suggested that this is because of a better understanding of roles and tactics team organization and to act collectively and individually on these parameters to reduce energy expenditure during the game to maintain a high-level performance throughout the season.

Motor imagery and tennis serve performance: the external focus efficacy.

There is now ample evidence that motor imagery (MI) contributes to enhance motor performance. Previous research also demonstrated that directing athletes' attention to the effects of their movements on the environment is more effective than focusing on the action per se. The present study aimed therefore at evaluating whether adopting an external focus during MI contributes to enhance tennis serve performance. Twelve high-level young tennis players were included in a test-retest procedure. The effects of regular training were first evaluated. Then, players were subjected to a MI intervention during which they mentally focused on ball trajectory and specifically visualized the space above the net where the serve can be successfully hit. Serve performance was evaluated during both a validated serve test and a real match. The main results showed a significant increase in accuracy and velocity during the ecological serve test after MI practice, as well as a significant improvement in successful first serves and won points during the match. Present data therefore confirmed the efficacy of MI in combination of physical practice to improve tennis serve performance, and further provided evidence that it is feasible to adopt external attentional focus during MI. Practical applications are discussed. Key PointsMotor imagery contributes to enhance tennis serve performance.Data provided evidence of the benefits of adopting an external focus of attention during imagery.Results showed significant improvement in successful first serves and won points during a real match.

Joint Kinetics to Assess the Influence of the Racket on a Tennis Player's Shoulder.

This study aimed at investigating the influence of three rackets on shoulder net joint moments, power and muscle activity during the flat tennis serve under field- conditions. A 6-camera Eagle(®) motion analysis system, operating at 256 Hz, captured racket and dominant upper limb kinematics of the serve in five tennis players under three racket conditions (A: low mass, high balance and polar moment, B: low three moments of inertia, and C: high mass, swingweight and twistweight). The electromyographic activity of six trunk and arm muscles was simultaneously recorded. Shoulder net joint moments and power were computed by 3D inverse dynamics. The results showed that greater shoulder joint power and internal/external rotation peak moments were found to accelerate and decelerate racket A in comparison with the racket C. Moreover, serving with the racket A resulted in less activity in latissimus dorsi muscle during the acceleration phase, and biceps brachii muscle during the follow-through phase when compared with racket C. These initial findings encourage studying the biomechanical measurements to quantify the loads on the body during play in order to reduce them, and then prevent shoulder injuries. Racket specifications may be a critical point for coaches who train players suffering from shoulder pain and chronic upper limb injuries should be considered in relation to the racket specifications of the players. Key PointsLight racket required more joint power than heavy one to achieve similar post impact ball velocity.Serving with a light racket resulted in higher shoulder internal and external rotation moments than using a heavy one for similar performance.Chronic shoulder pain should encourage coaches to check for potentially inappropriate racket specifications of their players.

Factors affecting the shoulder functional profile in elite judo athletes.

The aim was to investigate the effects of sex, age, preferred judo technique, dominance, and injury history on the shoulder functional status of elite judo athletes. Sixty-one elite judo athletes (38 males, age: 18.1 ± 1.2 years, body mass: 69.3 ± 13.3 kg, body height: 172.2 ± 9.8 cm, brown belt to second-degree black belt) completed three questionnaires: Western Ontario Shoulder Instability, Western Ontario Rotator Cuff, and Shoulder Instability-Return to Sport after Injury. They performed four physical tests: the glenohumeral rotator isometric strength test, upper quarter Y-balance test, unilateral seated shot put test, and modified Closed Kinetic Chain Upper Extremity Stability Test. The results showed that the female athletes had less shoulder functional abilities than the male athletes (p < 0.001 to p = 0.02). The younger athletes had poorer shoulder stability and upper extremity power than the older athletes (p < 0.001 to p = 0.02), but their glenohumeral muscles were stronger in both internal (p = 0.03) and external (p = 0.005) rotations. All the judo athletes had similar bilateral differences in shoulder functional status, except for judokas who preferred throwing techniques (p = 0.01). Injury history affected self-perceived functional status (p < 0.001), as well as upper extremity muscle capacity and neuromuscular control (p = 0.01 to p = 0.05). This study provides new insight into the shoulder functional status of elite judo athletes, which may aid in the development of sports-specific injury prevention and return-to-sport programmes to reduce the risk of shoulder injury occurrence and recurrence.HighlightsNormalized levels of upper extremity abilities must be sex- and age-specific in prevention programmes.Prevention programmes may focus on muscle bilateral and anteroposterior symmetry.Prevention programmes may include psychological training tailored to the sex of judo athletes.

Effects of an 8-week multimodal program on thoracic posture, glenohumeral range of motion and serve performance in competitive young tennis players.

Introduction: Intensive tennis practice is known to generate sport-specific adaptations at the shoulder region and influence the sagittal spinal curvature. However, increased thoracic kyphosis decreases the shoulder functional capacity, which could limit tennis performance. Therefore, the aim of this study was to investigate the effects of an 8-week multimodal program on thoracic posture, glenohumeral range of motion, and serve performance in competitive young tennis players. Methods: Eighteen male and four female players (age: 16.0 ± 2.4 years, height: 170.7 ± 11.0 cm; mass: 62.1 ± 11.5 kg; International Tennis Number: 3-4) performed their regular training during 8 weeks, which was used as a reference period, and implemented a multimodal program including stretching, strengthening, and myofascial release exercises, four times per week during 8 additional weeks, which corresponded to the intervention period. The thoracic curvature angle and mobility, the biacromial and interscapular distances, the glenohumeral range of motion and the tennis serve performance were assessed three times, i.e., before and after the regular training and after the 8-week multimodal program. Results: The results showed that the 8-week regular training had no significant effects on thoracic curvature angle [effect size (ES) = 0.02-0.36, p = 0.06-0.46] and mobility (ES = 0.05-0.26, p = 0.13-0.42), biacromial (ES = 0.05, p = 0.18) and interscapular distances (ES = 0.03, p = 0.45), ranges of motion in glenohumeral internal (ES = 0.04, p = 0.43) and external rotation (ES = 0.43, p = 0.06), and tennis serve accuracy (ES = 0.33, p = 0.07) and velocity (ES = 0.09, p = 0.35). The 8-week multimodal program increased moderately the thoracic mobility (ES = 0.55, p = 0.01), moderately to strongly the serve accuracy and velocity (ES = 0.65, p = 0.003, for both), strongly decreased the interscapular distance (ES = 1.02, p < 0.001), and strongly increased the range of motion in glenohumeral internal (ES = 0.90, p < 0.001) and external rotation (ES = 1.49, p < 0.001). Discussion: These findings indicated that an 8-week multimodal program, including spine and glenohumeral mobility and shoulder girdle strength exercises, performed four times per week during 8 weeks, is moderately relevant to rectify the sagittal thoracic curvature in competitive tennis players, while such a program may help regain the range of motion in glenohumeral rotation without tennis serve performance impairment.

Opposition Skill Efficiency During Professional Rugby Union Official Games Is Related to Horizontal Force-Production Capacities in Sprinting.

PURPOSE: This study aimed to determine relationships between parameters of force-production capacity in sprinting and opposition skill efficiency in rugby union games according to position. METHODS: The sprint force-velocity profile of 33 professional rugby union players divided into 2 subgroups (forwards and backs) was measured on a 30-m sprint. Skill efficiencies (in percentage) of offensive duels, tackles, and rucks were assessed using objective criteria during 12 consecutive competitive games. Pearson correlation was used to determine the relationships between parameters of horizontal force-production capacity in sprinting (maximum propulsive power, theoretical maximum force [F0], theoretical maximum velocity, maximum ratio of horizontal force [RFmax], and rate of decrease of this ratio of forces with increasing velocity) and skill efficiencies. Two multiple linear regression models were used to observe whether skill efficiencies could depend on determinants of horizontal force application in low- or high-velocity conditions. A first model including F0 and theoretical maximum velocity was used as a macroscopic analysis, while a second model including RFmax and rate of decrease of this ratio of forces with increasing velocity was used as microscopic analysis to determine the most significant determinants of skill efficiency. RESULTS: All skill efficiencies were strongly correlated with maximum propulsive power in forwards and backs. In forwards, F0 and RFmax were the key predictors of dueling, rucking, and tackling efficiency. In backs, F0 was the main predictor of dueling and rucking efficiency, whereas RFmax was the key predictor of dueling and tackling efficiency. F0 and theoretical maximum velocity equivalently contributed to tackling performance. CONCLUSIONS: In rugby union forward and back players, skill efficiency is correlated with maximum propulsive power and may be more explained by horizontal force-production capacity and mechanical effectiveness at lower velocities than at higher velocities.

Functional Deficits After Open Latarjet Procedure and Dominance of the Operated Shoulder: An Analysis of 133 Patients.

BACKGROUND: Return to sport after stabilization surgery using the open Latarjet procedure remains challenging. Additional knowledge is needed about postoperative shoulder functional deficits in order to better design return-to-sport programs. PURPOSE: To investigate the effects of the dominance status of the operated shoulder on the shoulder functional profile recovery at 4.5 months after open Latarjet procedure. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A retrospective analysis of prospectively collected data was performed. All patients who underwent the open Latarjet procedure between December 2017 and February 2021 were eligible for the study. Functional assessment at 4.5 months after the surgery was performed using the following tests: maximal voluntary isometric contractions in glenohumeral internal and external rotation, upper-quarter Y balance test, unilateral seated shot-put test, and modified closed kinetic chain upper extremity stability test, leading to 10 outcome measures. Patients whose dominant side had undergone surgery and those whose nondominant side had undergone surgery were compared with a group of 68 healthy control participants. RESULTS: A total of 72 patients who underwent an open Latarjet procedure on the dominant side and 61 patients who underwent open Latarjet on the nondominant side were compared with 68 healthy control athletes. In patients whose dominant shoulder had undergone surgery, significant deficits for the dominant side (P < .001) and for the nondominant side (P < .001) were found in 9 of 10 functional outcome measures. Among patients whose operations were on the nondominant shoulder, significant deficits for the nondominant side (P < .001) and for the dominant side (P < .001) were found in 9 and 5 of the 10 functional outcome measures, respectively. CONCLUSION: Regardless of dominance of the stabilized shoulder, persistent deficits in strength, stability, mobility, power, and stroke frequency were observed at 4.5 months postoperatively. Stabilization of the dominant shoulder resulted in residual surgery-related functional impairments on both sides. However, stabilization of the nondominant shoulder resulted in impairments primarily noted in the nondominant, operative shoulder. REGISTRATION: NCT05150379 (ClinicalTrials.gov identifier).

Impact of the Menstrual Cycle Phases on the Movement Patterns of Sub-Elite Women Soccer Players during Competitive Matches.

The purpose of this study was to evaluate the influence of the menstrual cycle phases on the movement patterns of sub-elite women soccer players during competitive matches over three consecutive seasons. Individual movement data were analyzed and compared in eight players from the second French League at the early follicular (EF), late follicular (LF) and mid-luteal (ML) phases of their menstrual cycle, determined by the calendar method. The movement patterns, expressed as meters per minute, were recorded during competitive matches using devices placed on the player's ankle. Our results showed significantly lower distances covered at moderate and high velocity in the EF phase than in the LF and ML phases (Cohen's d effect size = 1.03 and 0.79, respectively). The total distance covered during matches and the number of sprints also were reduced during EF compared with LF (d = 0.78 and 0.7, respectively). Overall, the total distance and distance covered at low velocity were significantly lower during the second half-time of the matches (d = 1.51), but no menstrual cycle phase × game period interaction was noted. In conclusion, our study suggests that EF may impact the movement pattern of sub-elite women soccer players during competitive matches, without any modulation of this effect by the playing time. Despite the low sample size, these results can be useful for coaches and support staff to modulate training loads and player rotation during soccer games.

Influence of Repeated-Sprint Ability on the in-Game Activity Profiles of Semiprofessional Rugby Union Players According to Position.

This study investigated the influence of repeated-sprint ability (RSA) on the activity of rugby union players in a competitive situation according to their position. Thirty-three semiprofessional rugby union players (age, 25.6 ± 4.3; height, 184.0 ± 8.0 cm; weight, 98.9 ± 13.9 kg, ~20 h training a week), divided into two position subgroups (forwards n = 20, backs n = 13) or four positional subgroups (front row and locks n = 13, back row n = 7, inside backs n = 6, outside backs n = 7), were tested. Their RSA was assessed with a 12 × 20 m sprint test over a 20 s cycle. GPS data (distance, acceleration, number of sprints, maximum velocity, and high-velocity running) and technical data were collected on 18 semiprofessional division rugby union games. In forwards, players with lower cumulated sprint time in the RSA test produced significantly more accelerations (ρ = -0.85, p < 0.001) and more combat actions per match minute (ρ = -0.69, p < 0.001). In backs, RSA was significantly correlated with high-intensity running [distance (ρ = -0.76), Vmax (ρ = -0.84), sprints frequency (ρ = -0.71), high-velocity running (ρ = -0.76), all p < 0.01]. Then, the players were divided into four subgroups (front row and locks, back row, inside backs and outside backs). RSA was significantly associated with the number of accelerations (ρ = -0.96, p <001) and combat actions in front row and locks (ρ = -0.71, p = 0.007). In the back row, RSA was correlated with distance (ρ = -0.96, p = 0.003) and the frequency of combat actions (ρ = -0.79, p = 0.04). In inside backs, RSA was significantly (all p < 0.01) correlated with distance (ρ = -0.81), number of accelerations (ρ = -0.94) and high-velocity running (ρ = -0.94), while in outside backs, RSA was associated with sprint frequency (ρ = -0.85) and the maximal in-game velocity reached (ρ = -0.89). These results demonstrate that RSA is associated with match running and combat activity performance (i) regardless of the position on the pitch and (ii) specifically for each player's position by improving the corresponding activity profile.

The S-STARTS Test: Validation of a Composite Test for the Assessment of Readiness to Return to Sport After Shoulder Stabilization Surgery.

BACKGROUND: The time elapsed since surgery is the primary criterion for allowing athletes to return to sport after shoulder stabilization surgery using the Latarjet procedure. The objective assessment of shoulder functional status through the return-to-sport continuum demands a scoring instrument that includes psychological and physical dimensions. This study aimed to statistically validate the Shoulder-SanTy Athletic Return To Sport (S-STARTS) score in patients who have undergone primary shoulder stabilization surgery. HYPOTHESIS: The S-STARTS score fulfils the criteria for statistical validation for assessing return-to-sport readiness after shoulder stabilization surgery. STUDY DESIGN: Diagnostic study. LEVEL OF EVIDENCE: Level 4. METHODS: Fifty patients and 50 controls completed the Shoulder Instability-Return to Sport after Injury questionnaire and performed 4 physical performance tests, from which 8 outcome measures were extracted to provide a composite score, named S-STARTS, according to a scoring procedure. The statistical validation of the S-STARTS score was based on construct validity, discriminant validity, sensitivity to change, internal consistency, reliability, agreement, and feasibility. RESULTS: The 8 components of the S-STARTS score provided additional information (0.01 ≤ |r| ≤ 0.59). The S-STARTS score exhibited good reliability (intraclass coefficient of correlation [3,k] = 0.74), no ceiling or floor effects, and high discrimination and sensitivity to change. The S-STARTS score was significantly lower in patients than in controls (13.5 ± 3.8 points vs 16.1 ± 2.7 points, respectively; P < 0.001). A significant increase was reported between 4.5 and 6.5 months postoperatively (12.8 ± 2.3 points vs 17.2 ± 2.4 points, respectively; P < 0.001). CONCLUSIONS: The S-STARTS score meets statistical validation criteria for the assessment of shoulder functional status after shoulder stabilization surgery using the Latarjet procedure. CLINICAL RELEVANCE: Using an S-STARTS score-based assessment to monitor an athlete's progression through the return-to-sport continuum may help clinicians and strength and conditioning coaches in return-to-sport decision-making.

Isokinetic Strength After ACL Reconstruction: Influence of Concomitant Anterolateral Ligament Reconstruction.

BACKGROUND: To reduce the rate of anterior cruciate ligament (ACL) graft rupture, recent surgeries have involved anterolateral ligament reconstruction (ALLR). This reconstruction procedure harvests more knee flexor muscle tendons than isolated ACL reconstruction (ACLR), but its influence on knee muscle strength recovery remains unknown. This study aimed to assess the influence of ALLR with a gracilis graft on the strength of the knee extensor and flexor muscles at 6 months postoperatively. HYPOTHESIS: The additional amount of knee flexor harvest for ALLR would result in impairment in knee flexor muscle strength at 6 months postoperatively. STUDY DESIGN: Retrospective cohort study. LEVEL OF EVIDENCE: Level 2. METHODS: A total of 186 patients were assigned to 2 groups according to the type of surgery: ACL + ALLR (graft: semitendinosus + gracilis, n = 119) or isolated ACLR (graft: semitendinosus, n = 67). The strength of the knee extensor and flexor muscles was assessed using an isokinetic dynamometer at 90, 180, and 240 deg/s for concentric and 30 deg/s for eccentric contractions and compared between groups using analysis of variance statistical parametric mapping. RESULTS: Regardless of the surgery and the muscle, the injured leg produced significantly less strength than the uninjured leg throughout knee flexion and extension from 30° to 90° for each angular velocity (30, 90, 180, and 240 deg/s). However, the knee muscle strength was similar between the ACL + ALLR and ACLR groups. CONCLUSION: The addition of ALLR using the gracilis tendon during ACLR does not alter the muscle recovery observed at 6 months postoperatively. CLINICAL RELEVANCE: Although more knee flexor muscle tendons were harvested in ACL + ALLR, the postoperative strength recovery was similar to that of isolated ACLR.