Motor alterations along the kinetic chain in amateur volleyball and handball athletes with shoulder pain: An observational comparative study.

Overhead sports overload the shoulder complex due to movement repetition and the great amount of force created during the athletic motion, which may cause adaptations in the shoulder and lead to shoulder pain. However, overhead movements include the kinetic chain, and alterations in some of the structures throughout the kinetic chain may increase stress on the shoulder complex and be associated with shoulder pain. PURPOSE: To compare kinetic chain components in overhead athletes with and without shoulder pain. METHODS: Forty-one volleyball and handball athletes (21 with and 20 without shoulder pain) were included and assessed for hip internal (IR) and external rotation (ER) range of motion (ROM), hip and trunk isometric strength, trunk endurance and neuromuscular control of the lower and upper limbs (Y balance test). RESULTS: Athletes with shoulder pain showed smaller IR ROM in both hips, lower endurance time for trunk extensors and flexors, decreased reach distance in the anterior and posteromedial direction, as well as a smaller composite score in the Y balance test (p < 0.05). CONCLUSION: Volleyball and handball athletes with shoulder pain showed changes in ROM throughout the kinetic chain in addition to lower core endurance, and decreased neuromuscular control of lower limbs.

Correlation between upper limb function and clinical measures of shoulder and trunk mobility and strength in overhead athletes with shoulder pain.

OBJECTIVE: To investigate the correlation between functional performance and self-reported upper limb function and between these two functional measures and clinical measures of shoulder and trunk in overhead athletes with shoulder pain. DESIGN: Cross-sectional study. SETTINGS: Laboratory. PARTICIPANTS: Twenty-one volleyball and handball athletes (23.6 ± 3.7 years) with shoulder pain in the dominant limb. MAIN OUTCOME MEASURES: Self-reported dominant upper limb function using Penn Shoulder Score and Disabilities of the Arm, Shoulder, and Hand; shoulder and trunk range of motion; isometric strength of shoulder, periscapular, and trunk muscles; endurance time of trunk muscles; and functional upper limb performance using the Upper Quarter Y-Balance Test (UQYBT). RESULTS: A moderate correlation was observed (r = 0.45-0.58; p < 0.05) between UQYBT performance and strength of serratus anterior, lower trapezius, trunk rotators, and trunk flexors. No significant correlation was observed between UQYBT performance and the other clinical measures of shoulder and trunk (r = 0.01-0.39, p > 0.05). Self-reported upper limb function was neither significantly correlated with clinical measures (r = 0.01-0.40, p > 0.05) nor with UQYBT performance (r = 0.02-0.19, p > 0.05). CONCLUSION: We observed a correlation between UQYBT performance and strength of periscapular and trunk muscles.