Injury prevention in Brazilian women's football: Perceptions of physiotherapists and practices within elite clubs.

OBJECTIVES: To describe the perceptions of physiotherapists and the injury prevention practices implemented within elite women's football clubs in Brazil. DESIGN: Cross-sectional study. SETTING: Online survey. PARTICIPANTS: Head physiotherapists from 32 Brazilian elite clubs. MAIN OUTCOME MEASURES: Structured questionnaire. RESULTS: Physiotherapists identified ACL rupture as the primary target for prevention. The top-five perceived injury risk factors included 'early return to sport after injury', 'workload too high', 'previous injury', 'poor sleep/rest', and 'muscle strength/power deficit'. 'Adoption of return to sport criteria' was almost unanimously recognized as a very important preventive strategy. 'Poor infrastructure' was elected as the main barrier to implementing prevention programs. From a practical standpoint, at least two-third of clubs implemented multi-component exercise interventions for injury prevention. These interventions typically encompassed flexibility/mobility, balance/proprioception, lumbo-pelvic stability, and agility exercises, alongside exposure to sprinting. Strength training routines typically included traditional, functional, and eccentric exercises. Most teams also employed other prevention strategies, including adoption of return to sport criteria, internal workload monitoring, post-exercise recovery modalities, preseason risk factor screening, and application of rigid strapping tapes. CONCLUSIONS: This study provided unprecedented insights into the physiotherapists' perceptions and injury prevention practices implemented within elite women's football clubs.

Missing The Forest For The Trees: A Lack Of Upper Extremity Physical Performance Testing In Sports Physical Therapy.

Background: Despite shoulder and elbow injuries being common in athletics, return to sport and reinjury rates are less than ideal. These outcomes may be driven by the absence of evidence-informed testing to determine an athlete's readiness for sport. Purpose: The purpose of this study was to explore the reported frequency of physical performance testing for return to sport readiness by physical therapists treating athletes with upper extremity injuries and to identify potential barriers that may limit use of these tests. A secondary aim was to compare practice patterns of clinicians with sports physical therapy specialty certification to clinicians without. Study Design: International, cross-sectional survey using purposive sampling. Methods: A survey instrument was created to assess the frequency of use of physical performance tests by physical therapists treating athletes with upper extremity injuries, as well as the barriers limiting the use of these tests. The 19-question online survey was distributed via email and Twitter among sports physical therapists. Independent t-tests and Chi Square analyses were conducted to determine differences in practice patterns between physical therapists with and without specialization and the frequency of potential barriers that may limit the use of these tests. Results: Four hundred ninety-eight participants met study eligibility and completed the survey. Fewer than half of participants reported using any physical performance test in making return to sport decisions for athletes with upper extremity injuries. The greatest barriers to the use of physical performance tests were a lack of equipment followed by lack of understanding of the literature, lack of time, and lack of supporting literature. Sports specialist clinicians were significantly more likely (p<0.001) to use physical performance tests than non-specialist clinicians (71.6% versus 36.3%). Conclusion: In this survey of physical therapists (n=498), the majority admit to not using physical performance tests when making return to sport decisions for athletes with upper extremity injuries regardless of specialization.Physical therapists have an opportunity to improve the utilization physical performance testing in the upper extremity athlete in hopes of reducing injury recurrence and enhance return to sport rates. Level of Evidence: Level 3b.

Association of trunk and lower limb factors with shoulder complaints and sport performance in overhead athletes: A systematic review including GRADE recommendations and meta-analysis.

OBJECTIVE: To identify the association of trunk and lower limb factors with shoulder complaints and sport performance in overhead athletes. METHODS: Search performed at PubMed/Medline, Embase, CINAHL, LILACS, Cochrane, Web of Science and SPORTDiscus for observational studies. Methodological quality and strength of the evidence was assessed with the Newcastle-Ottawa Scale and GRADE. Meta-analysis and effects sizes analysis were calculated when possible. RESULTS: Sixty-five studies were included. Low to very-low evidence suggests no association of trunk/lower limb strength, endurance, power, jump or balance with shoulder complaints and/or throwing performance. Athletes with shoulder complaints performed worse in trunk stability and endurance tests (mean difference: -6.83 (95%CI: -8.78, -4.88)). Athletes with high throwing performance presented better results in CMJ, horizontal jump, power measures and knee extension strength. For swimmers, there was no association of trunk/lower limb endurance with shoulder complaints (moderate evidence) and no association of balance and swimming performance (low evidence). Better trunk/lower limb strength, power and vertical jumps measures were associated with better swimming performance. CONCLUSIONS: In methodologically similar studies, some trunk/lower limb outcomes are associated with shoulder complaint or sport/swimming performance. Results should be considered with caution and future studies should use better methodologies.

Influence of quarantine during the coronavirus disease 2019 (COVID-19) pandemic on physical and psychosocial aspects: perceptions of 214 Brazilian athletes.

Background: Social distancing may affect athletes' training, causing negative effects on mental and physical health. Objective: This study therefore aimed to characterize the perception of Brazilian athletes about their physical and psychosocial aspects, sleep quality and coping strategies during the quarantine of the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a cross-sectional study with online survey, performed with Brazilian athletes (amateur and professional) over 18 years. The main outcomes measures assessed were physical and psychosocial aspects, sleep quality and coping strategies. Results: A total of 214 athletes were included. The average weekly hours of training during the quarantine was 4.71 ± 3.71 h, of which 64.5% athletes (138/214) were oriented by medical staff during training. For 52.8% (113/214) of athletes, training intensity during the quarantine was different/very different from the intensity before the quarantine. 79.4% athletes (170/214) reported moderate to extreme difficulties in keeping the same level of training during the quarantine. 77.1% athletes (165/214) had moderate to extreme anxiety and each of the athletes had concern about his or her athletic career future, including return to the sport. 72.9% athletes (156/214) reported change in sleep schedule during the quarantine period. Conclusion: The quarantine period during COVID-19 pandemic negatively affected the athlete's perception about training routine, since athletes reported reduction in training hours and training intensity. Overall, the athletes reported that they were moderately to extremely anxious. They also had concerns about their career in the future, as well as concerns regarding return to sport.

Influence of lower limb torque, range of motion, and foot alignment in patellar rotation (Arno angle) in athletes.

BACKGROUND: Alterations of frontal plane patellar alignment could be related to lower limb disorders. Clinical assessment must be able to identify the influence of non-local factors in patellar alignment. OBJECTIVE: To identify the influence of lower limb torque, range of motion (ROM), and foot alignment on patellar rotation in healthy athletes. METHODS: This cross-sectional study was performed with 232 healthy basketball and volleyball elite athletes. Participants were assessed in preseason for: patellar medial and lateral rotation (Arno angle), passive hip internal rotation (IR) ROM, iliotibial band flexibility, hip abductors and external rotators (ER) torque, shank-forefoot alignment (SFA), and ankle dorsiflexion ROM. Hierarchical multiple linear regression was performed to identify if these variables and sex, age, and body mass could be associated with patellar rotation in a standing position. RESULTS: Hip ER isometric torque explained a small part (10%) of the variance of the Arno angle in healthy athletes (R² change=0.10; unstandardized ß=11.74 (95% CI 6.82, 16.65); Standardized Coefficient Beta=0.32) and sex explained 2% of its variance (R² change=0.02; unstandardized ß= 2.42 (95% CI 0.32, 4.52); Standardized Coefficient Beta=0.15). After controlling for sex, hip ER torque explained 9% of Arno angle variance (R² change=0.09; unstandardized ß= 11.09 (95% CI 6.43, 15.76; Standardized Coefficient Beta=0.31). The other variables were not associated with patellar rotation. CONCLUSIONS: Hip ER torque may influence patellar rotation in different directions (medial or lateral rotation). Possible mechanisms that explain the contribution of higher and lower hip ER torque in lateral and medial patellar rotation, respectively, are discussed.

Is the isometric strength of the shoulder associated with functional performance tests in overhead athletes?

OBJECTIVE: To verify the association of the isometric strength of the shoulder external rotators (ER) and serratus anterior (SA) with the performance of functional tests CKCUEST, SMB-T, and USSP-T in overhead athletes. DESIGN: Cross-sectional study. PARTICIPANTS: Eighty overhead athletes with no history of surgery in the upper and lower limbs and trunk in the past year, and no painful symptoms in the upper body during the physical assessment were included. MAIN OUTCOME MEASURES: Preseason assessment included isometric strength of shoulder ER and SA, and performance of the CKCUEST, SMB-T, and USSP-T. Multiple linear regression analysis was performed to identify if the isometric strength of the shoulder ER and SA could explain the performance during the tests after controlling for sex. RESULTS: The isometric strength of SA was associated (p < 0.05) with the SMB-T and USSP-T with 4% of explain. The isometric strength of the SA was not associated (p > 0.05) with the CKCUEST. The isometric strength of the ER was not associated (p > 0.05) with any of the tests. CONCLUSION: The isometric strength of the SA predicted the SMB-T and USSP-T performance. Isometric strength of SA and shoulder ER was not associated with CKCUEST results in athletes overhead.

Sports injury prevention programmes from the sports physical therapist's perspective: An international expert Delphi approach.

OBJECTIVE: To provide consensus on how to plan, organize and implement exercise-based injury prevention program (IPP) in sports. DESIGN: Delphi. SETTING: LimeSurvey platform. PARTICIPANTS: Experienced sports physical therapists from the International Federation of Sports Physical Therapy member countries. MAIN OUTCOME MEASURES: Factors related to sports IPP planning, organization and implementation. RESULTS: We included 305 participants from 32 countries. IPP planning should be based on an athlete's injury history, on pre-season screening results, and on injury rates (respectively, 98%, 92%, 89% agreement). In total 97% participants agreed that IPP organization should depend on the athlete's age, 93% on the competition level, and 93% on the availability of low-cost materials. It was agreed that IPP should mainly be implemented in warm-up sessions delivered by the head or strength/conditioning coach, with physical training sessions and individual physical therapy sessions (respectively, 94%, 92%, 90% agreement). CONCLUSION: Strong consensus was reached on (1) IPP based on the athlete's injury history, pre-season screening and evidence-based sports-specific injury rates; (2) IPP organization based on the athlete's age, competition level, and the availability of low-cost materials and (3) IPP implementation focussing on warm-up sessions implemented by the strength/conditioning coach, and/or individual prevention sessions by the physical therapist.

Hip external rotation isometric torque for soccer, basketball, and volleyball athletes: normative data and asymmetry index.

BACKGROUND: Deficits in strength of the hip external rotators (ER) affect trunk, hip, and knee movement patterns, potentially contributing to injury in athletes. OBJECTIVES: To provide normative data on isometric torque for hip ER in athletes of three distinct sports and to determine if isometric torque for the hip ER and torque asymmetry between legs differ among sports and between sexes. METHODS: Basketball, soccer, and volleyball athletes (n=451) were evaluated. Hip ER torque was quantified bilaterally with athletes in prone and 90° of knee flexion using a hand-held dynamometer. RESULTS: Data are expressed as mean and 95% confidence interval. Hip ER torque values in Nm/kg for the dominant and non-dominant limbs were, respectively, 0.46 (0.44, 0.48) and 0.42 (0.40, 0.44) for male soccer athletes; 0.35 (0.32, 0.37) and 0.27 (0.25, 0.29) for male basketball athletes; and 0.37 (0.34, 0.39) and 0.35 (0.32, 0.37) for male volleyball athletes. Hip ER torque in Nm/kg for the female volleyball athletes was 0.29 (0.26, 0.33) for the dominant and 0.29 (0.25, 0.32) for the non-dominant limb. The Limb Symmetry Index for male soccer, basketball, and volleyball players was, respectively, 94% (91, 97), 81% (75, 87), and 95% (91, 99). For female volleyball players the Limb Asymmetry Index was 102% (95, 108). Male volleyball athletes showed higher torque values than female volleyball athletes. CONCLUSIONS: This study reported normative values for hip ER isometric torque of youth athletes. Clinicians can use the reported data as reference to identify torque deficits in athletes of the three reported sports.

Preventive effect of tailored exercises on patellar tendinopathy in elite youth athletes: A cohort study.

OBJECTIVE: To investigate the effects of an intervention with tailored exercises on the incidence of patellar tendinopathy (PT) in elite youth jumping athletes. DESIGN: Prospective crossover cohort. SETTING: One sport club facility. PARTICIPANTS: 271 elite youth basketball and volleyball player were followed in the first year of the study (Observation year) and 270 athletes were followed in the second year (intervention year). MAIN OUTCOME MEASURE: Incidence rates of PT per 1,000h of exposure. Cox survival analysis was used to verify the effects of the intervention (exercises implemented according to the findings of a preseason assessment) on PT incidence. RESULTS: The exercise prevention program significantly reduced the number of cases of PT, with athletes submitted to the intervention showing 51% less risk of developing PT. The overall PT incidence in the Observation year (5.9 per 1,000h of exposure) was significantly higher than that in the intervention year (2.8 per 1,000h of exposure) (P = .037). Twenty-six athletes developed PT in the observation year, whereas 13 athletes developed PT in the intervention year. CONCLUSIONS: A tailored preventive program may be able to reduce the incidence of patellar tendinopathy, especially in male youth volleyball athletes. Randomized controlled trials are encouraged to confirm these findings.

The Brazilian hip and groin outcome score (HAGOS-Br): cross-cultural adaptation and measurement properties.

BACKGROUND: Hip and groin pain or symptoms is a recurrent musculoskeletal complaint among young and active individuals. It is important to objectively measure functional limitations using patient-related outcomes that have been validated in the language of the target population. OBJECTIVES: To perform a cross-cultural adaptation and to evaluate the measurement properties of the Hip and Groin Outcome Score (HAGOS) for the Brazilian population. METHODS: We adapted the HAGOS to Brazilian Portuguese and evaluated the following measurement properties: internal consistency, test-retest reliability, measurement error, and structural and construct validity. The sample recruited consisted of active individuals between 18 and 55 years of age with long standing hip and groin pain and individuals who participated in sports with high physical demand of the hip and groin region. RESULTS: A total of 103 athletes and physically active individuals of both sexes participated in this study. The HAGOS was successfully translated and culturally adapted to the Brazilian population. Factor analysis confirmed that the HAGOS consists of six subscales. The HAGOS-Br showed good internal consistency. The CFA revealed a Cronbach's alpha for the HAGOS subscales ranging from 0.86 to 0.96, test-retest reliability was substantial, with intraclass correlation coefficients ranging from 0.81 to 0.94 for the six subscales and an acceptable measurement error (standard error of measurement [SEM]=5.43-11.15 points; and smallest detectable chance [SDC]= 16.71-30.9 points). Good construct validity existed with more than 75% of the pre-defined hypotheses being confirmed. No ceiling or floor effects were observed. CONCLUSION: The HAGOS-Br showed to be equivalent to the original version with adequate validity and reliability properties.

Hip passive stiffness is associated with hip kinematics during single-leg squat.

INTRODUCTION: Single-leg squat (SLS) is a test commonly used to assess lower limb function in rehabilitation. Increased hip adduction and internal rotation (IR) is associated with dynamic knee valgus, which is related to hip and knee overload. Proximal and distal factors, such as hip passive stiffness, poor hip muscle strength and excessive foot misalignment may influence hip movement. However, previous studies focus on how proximal and distal factors affected knee joint movement and did not reported the influence on hip joint. OBJECTIVE: This study investigated the association of hip external rotators (ER) strength, hip passive stiffness and shank-forefoot alignment (SFA) with hip adduction and IR during SLS. DESIGN: Cross-sectional study. METHOD: Forty-six health participants of both sexes (23.47 ± 4.29 years, 60.40 ± 11.28 kg, 1.67 ± 8.9 m) had SFA, hip ER torque, hip passive stiffness and hip kinematics assessed. Multiple linear regressions were performed to identify the factors which associated with mean and peak hip adduction and IR movement during SLS. RESULTS: Only hip passive stiffness was associated with mean (R2 = 0.164; Confidence Interval (CI) 95% = [-0.250, -0.048]; p = 0.005) and peak (R2 = 0.116; CI 95% = [-0.223, -0.210]; p = 0.019) hip IR movement. CONCLUSION: Hip passive stiffness was associated with mean and peak hip IR movement during the SLS. These results suggest that individuals with reduced hip passive stiffness may demonstrate increased hip IR movement during SLS.

Return to sport decisions after an acute lateral ankle sprain injury: introducing the PAASS framework-an international multidisciplinary consensus.

BACKGROUND: Despite being the most commonly incurred sports injury with a high recurrence rate, there are no guidelines to inform return to sport (RTS) decisions following acute lateral ankle sprain injuries. We aimed to develop a list of assessment items to address this gap. METHODS: We used a three-round Delphi survey approach to develop consensus of opinion among 155 globally diverse health professionals working in elite field or court sports. This involved surveys that were structured in question format with both closed-response and open-response options. We asked panellists to indicate their agreement about whether or not assessment items should support the RTS decision after an acute lateral ankle sprain injury. The second and third round surveys included quantitative and qualitative feedback from the previous round. We defined a priori consensus being reached at >70% agree or disagree responses. RESULTS: Sixteen assessment items reached consensus to be included in the RTS decision after an acute lateral ankle sprain injury. They were mapped to five domains with 98% panellist agreement-PAASS: Pain (during sport participation and over the last 24 hours), Ankle impairments (range of motion; muscle strength, endurance and power), Athlete perception (perceived ankle confidence/reassurance and stability; psychological readiness), Sensorimotor control (proprioception; dynamic postural control/balance), Sport/functional performance (hopping, jumping and agility; sport-specific drills; ability to complete a full training session). CONCLUSION: Expert opinion indicated that pain severity, ankle impairments, sensorimotor control, athlete perception/readiness and sport/functional performance should be assessed to inform the RTS decision following an acute lateral ankle sprain injury. TRIAL REGISTRATION NUMBER: ACTRN12619000522112.

Correlation between goniometric and photogrammetric assessment of shank-forefoot alignment in athletes.

BACKGROUND: The shank-forefoot alignment (SFA) measurement has been previously developed to enhance the applicability of foot alignment measurement in sports preseason assessment because it is reliable and less time consuming. The use of SFA measurements in the clinical context, usually done with photogrammetry, may be simplified by using the universal goniometer and no longer requiring the image processing step that takes additional time and equipment. OBJECTIVE: Investigate the correlation between the goniometric and photogrammetric assessment of shank-forefoot alignment in athletes. PARTICIPANTS: Thirty volleyball athletes were recruited during a preseason assessment. METHODS: SFA measurements were assessed with a universal goniometer and photogrammetry. For both assessments the participants were positioned in prone with the rearfoot facing up and the ankle actively maintained in 90° of dorsiflexion. The examiner did not have access to the SFA outcome values from both measurements. A second examiner did the bi-dimensional analysis with SIMI MOTION (photogrammetric measure) and read the goniometer measures during the other SFA assessment. Data normality was tested using Shapiro-Wilk test and Pearson was used to determine the correlation between both measurements. RESULTS: A reliability study determined the Intraclass Correlation Coefficient (ICC3,3) for intra-rater reliability of 0.93 for photogrammetry and of 0.81 for goniometry assessment. The correlation (p < 0.001) between these two measurements was 0.71, which indicates a moderate relationship. CONCLUSIONS: This study describes a reliable and practical measurement procedure for shank-forefoot alignment using the universal goniometer that can be easily applied in clinical context.

Interventions used for Rehabilitation and Prevention of Patellar Tendinopathy in athletes: a survey of Brazilian Sports Physical Therapists.

OBJECTIVES: (1) To identify the type and frequency of interventions used by Brazilian physical therapists to treat and prevent the occurrence of patellar tendinopathy in athletes and the criteria used to return to sport; (2) to compare the interventions used to the grade of recommendation of current evidence. METHODS: Design: cross-sectional study. SETTING: online survey throughout sports physical therapy association. PARTICIPANTS: Physical therapists who were invited to complete a structured questionnaire. MAIN OUTCOME MEASURES: Interventions more frequently used for treating and preventing PT in athletes and the criteria used to define return to sport. RESULTS: One-hundred and twenty-one physical therapists participated in this study. Quadriceps eccentric strengthening (75.2%), education (61.2%) and lower limb joint/lumbo-pelvic stabilization/hamstrings stretching (59.5%) were more frequently cited for prevention purposes, while lower limb joint stabilization (81.8%), education (80.2%) and myofascial release (78.5%) were more frequently reported for treatment. The majority of the physical therapists based their decision of athlete discharge on a combination of pain intensity, function and functional test results (44.6%). CONCLUSION: There was inconsistency between interventions used in clinical practice and interventions recommended by the best available evidence.

Does trunk and hip muscles strength predict performance during a core stability test?

BACKGROUND: A better understanding about the relationship between trunk and hip muscles strength and core stability may improve evaluation and interventions proposed to improve core stability. OBJECTIVES: To investigate if trunk and hip muscles strength predict pelvic posterior rotation during the bridge test with unilateral knee extension. METHODS: This is a cross-sectional study. Sixty-one healthy individuals of both sexes (age, 28±6.4 years, weight, 66.5±10.9kg, height, 167±9.5cm) performed the bridge test with unilateral knee extension. The pelvic posterior rotation during the bridge test was obtained with two-dimensional video analysis. Isometric strength of the trunk extensors and rotators, and hip abductors, external and internal rotators and extensors were measured with a hand-held dynamometer. Multiple linear regression analysis was performed to identify if the strength variables could explain the pelvic posterior rotation during the test. RESULTS: Muscle strength predicted pelvic posterior rotation during the bridge test (r=0.54; p=0.003). Strength of the trunk rotators (p=0.045) and hip internal rotators (p=0.015) predicted reduced magnitude of pelvic posterior rotation during the bridge test, and strength of the hip extensors (p=0.003) predicted increased magnitude of pelvic posterior rotation. CONCLUSIONS: Trunk rotators and hip internal rotators and extensors strength predict 29% of the performance during the bridge test with unilateral knee extension. The strength of these muscles should be evaluated in individuals with increased pelvic posterior rotation during the bridge test with unilateral knee extension.

How strong is the evidence that conservative treatment reduces pain and improves function in individuals with patellar tendinopathy? A systematic review of randomised controlled trials including GRADE recommendations.

OBJECTIVE: To determine the effectiveness of conservative treatment (CT) on pain and function in patients with patellar tendinopathy (PT) compared with minimal intervention (MI) or other invasive intervention, or in addition to decline eccentric squat. METHODS: Searches were performed in MEDLINE, Embase, Cochrane, PEDro, SPORTDiscus, CINAHL and AMED databases. All randomised trials that evaluated CT (any intervention not involving invasive procedures or medication) in individuals with PT were included. Two reviewers screened studies, extracted data and assessed risk of bias of all included studies. Where suitable, meta-analyses were conducted; we assessed certainty of the evidence using GRADE methodology. RESULTS: When compared with MI, CT did not improve pain (weighted mean difference (WMD) -2.6, 95% CI -6.5 to 1.2) or function (WMD 1.8, 95% CI -2.4 to 6.1) in the short-term (up to 3 months) follow-up. When compared with invasive intervention, CT did not improve pain (WMD 0.7, 95% CI -0.1 to 1.4) or function (WMD -6.6, 95% CI -13.3 to 0.2) in the short-term follow-up. No overall effects were found for combined CT (when a conservative intervention was added to decline eccentric squat) on pain (WMD -0.5, 95% CI -1.4 to 0.4) or function (WMD -2.3, 95 % -9.1 to 4.6) at short-term follow-up. Single studies showed an effect on pain with iontophoresis at short-term follow-up (d = 2.42) or dry needling at medium/long-term follow-up (d = 1.17) and function with exercise intervention at medium/long-term follow-up (over 3 months) (d = 0.83). SUMMARY/CONCLUSION: Our estimates of treatment effect have only low to very low certainty evidence to support them. This field of sports medicine/sports physiotherapy urgently needs larger, high-quality studies with pain and function among the potential primary outcomes.

Comparison of glenohumeral joint rotation range of motion in young athletes / Comparação da amplitude de movimento de rotação da articulação glenoumeral em atletas jovens / Comparación de la amplitud de movimiento de rotación de la articulación glenohumeral en atletas jóvenes

ABSTRACT Introduction: Overhead-throwing athletes undergo changes in shoulder range of motion (ROM) due to sports activities, such as excessive amplitude, lateral rotation (LR) increase and medial rotation (MR) restriction. Asymmetry greater than 20° may render athletes more prone to injuries. There are similarities among sports featuring overhead throwing due to the considerable amount of movements involving maximum lateral rotation. In these sports, medial rotation (MR) restriction, excess of lateral rotation (LR) and shoulder pain are common, particularly in overhead-throwing athletes. Objective: To assess shoulder MR and LR ROM in athletes participating in different sports, considering the influence of these variables on injuries and functional performance. Methods: The rotation ROM of the glenohumeral joint was assessed in 477 young athletes, who were categorized in three sports groups: swimming, overhead-throwing and non-overhead throwing, distributed by age group. Analyses of Variance (ANOVA) were performed to verify if there were differences in MR and LR between groups and paired Student t test was used to verify differences between sides (asymmetry). Results: Youngest athletes showed significant shorter LR than the oldest, in both sides. This study demonstrated that the right side has less MR and greater LR in all groups. Conclusion: The findings showed that overhead-throwing and swimming groups have similarities in shoulder rotation ROM. Level of evidence III; Diagnostic Studies - Investigating a Diagnostic Test.

RESUMO Introdução: Os atletas arremessadores sofrem adaptações na amplitude de movimento (ADM) do ombro, como amplitude excessiva, ganho de rotação lateral (RL) e restrição de rotação medial (RM) devido à prática esportiva. Uma assimetria maior que 20° pode tornar o atleta mais suscetível a lesões. Existem semelhanças entre os esportes que utilizam arremesso devido à ampla quantidade de movimentos em rotação lateral máxima. Nesses esportes, a restrição de rotação medial (RM), o excesso de rotação lateral (RL) e as dores no ombro são frequentes, principalmente, em atletas que são expostos aos arremessos. Objetivo: Avaliar a ADM de RM e RL do ombro de atletas de diferente modalidades esportivas considerando sua influência nas lesões e no desempenho funcional. Métodos: Avaliou-se a ADM de rotação da articulação glenoumeral em 477 atletas jovens. Os atletas foram categorizados em três grupos de esportes: natação; arremesso e não-arremesso, distribuídos em relação à faixa etária. As Análises de Variância (ANOVA) foram realizadas para verificar diferenças nas RM e RL entre os grupos e o Teste t Student pareado para verificar diferenças entre os lados (assimetria). Resultados: Os atletas mais novos apresentaram média de RL significativamente menor em relação aos mais velhos, em ambos os lados. O presente estudo demonstrou que o lado direito possui menor RM e maior RL em todos os grupos. Conclusão: Os achados desse estudo comprovaram que os grupos de arremesso e natação têm características semelhantes quanto à ADM de rotação do ombro. Nível de evidência III; Estudos diagnósticos - Investigação de um exame para diagnóstico.

RESUMEN Introducción: Los atletas lanzadores sufren adaptaciones en la amplitud de movimiento (ADM) del hombro, como amplitud excesiva, aumento de rotación lateral (RL) y restricción de rotación medial (RM), debido a la práctica deportiva. Una asimetría mayor que 20° puede hacer que el atleta sea más susceptible a las lesiones. Hay similitudes entre los deportes que utilizan el lanzamiento debido a la gran cantidad de movimientos en rotación lateral máxima. En estos deportes, la restricción de rotación medial (RM), exceso de rotación lateral (RL) y dolores en el hombro son frecuentes, principalmente en atletas que están expuestos a los lanzamientos. Objetivo: Evaluar la ADM de RM y RL del hombro de atletas de diferentes modalidades deportivas teniendo en vista su influencia en las lesiones y en el desempeño funcional. Métodos: Se evaluó la ADM de rotación de la articulación glenohumeral en 477 atletas jóvenes. Los atletas se clasificaron en tres grupos de deportes: natación; lanzadores y no Lanzadores, distribuidos con relación al grupo de edad. Los análisis de varianza (ANOVA) se realizaron para verificar diferencias en las RM y RL entre los grupos y el test t Student pareado para verificar diferencias entre los lados (asimetría). Resultados: Los atletas más jóvenes presentaron un promedio de RL significativamente menor con relación a los más viejos, en ambos lados. Este estudio demostró que el lado derecho posee menor RM y mayor RL en todos los grupos. Conclusión: Los hallazgos de este estudio comprobaron que los grupos de lanzadores y natación tienen características similares cuanto a la ADM de rotación del hombro. Nivel de evidencia III; Estudios de diagnósticos - Investigación de un examen para diagnóstico.