Adaptive changes in the dominant shoulders of female professional overhead athletes: mutual association and relation to shoulder injury

作者：Tonin Katarina^*; Strazar Klemen; Burger Helena; Vidmar Gaj

来源：International Journal of Rehabilitation Research, 2013, 36(3): 228-235.

DOI：10.1097/MRR.0b013e32835d0b87

• glenohumeral internal rotation deficit
• glenohumeral muscular imbalance
• overhead athletes
• SICK scapula syndrome

The aim of our study was to evaluate adaptive changes in the dominant shoulders of female professional overhead athletes, their mutual association, and relation between adaptive changes and shoulder injury. Thirty-six female professional volleyball and handball players were divided into two groups: 14 athletes were included in the symptomatic group (positive shoulder injury history and specific shoulder tests) and 22 athletes were included in the asymptomatic group (negative shoulder injury history and specific shoulder tests). Clinical examinations with specific shoulder tests, evaluation of rotational mobility, and symptoms of malposition and dyskinesis of the dominant scapula (SICK scapula syndrome) were performed. Glenohumeral rotators were isokinetically tested at 60 and 150 degrees/s, with evaluation of stability ratios and rotator fatigability. On average, the participants had decreased internal rotation (P%26lt;0.001) and increased external rotation (P%26lt;0.001), lower spiking (P%26lt;0.01 at 60 and 150 degrees/s) and conventional ratios (P %26lt;= 0.01 at 60 and 150 degrees/s), lower eccentric external rotator peak torques (eER) (P %26lt;= 0.05 at 60 and 150 degrees/s), and marginally lower eccentric internal rotator peak torques at 60 degrees/s (P=0.061) on the dominant side compared with the nondominant side. The symptomatic group showed decreased ER (P=0.021), higher deficit of dominant eER at 60 degrees/s (P=0.049), and higher fatigability of internal (P=0.013) and external rotators (P=0.028). The athletes with increased ER had more scapular lateralization (rho=0.340, P=0.042), higher spiking ratios at 60 degrees/s (rho=0.349, P=0.037) and 150 degrees/s (rho=0.330, P=0.049), and lower cocking ratios at 60 degrees/s (rho= -0.477, P=0.003). Decreased dominant ER, higher deficit of dominant eccentric ER peak torques, and higher dominant rotator fatigability correlate with previous shoulder pain/injury. Different adaptive changes (rotational mobility, SICK scapula signs, and glenohumeral muscular imbalance) are inter-related. As a form of both prevention and rehabilitation for the athletes at risk, we recommend individually adjusted shoulder training on the basis of clinical and isokinetic testing.

• 出版日期2013-9