Vol.:(0123456789) 1 3
Knee Surg Sports Traumatol Arthrosc
DOI 10.1007/s00167-017-4426-9
SHOULDER
Rotational glenohumeral adaptations are associated with shoulder
pathology in professional male handball players
Przemyslaw Lubiatowski
1,2
· Piotr Kaczmarek
2
· Pawel Cisowski
2
·
Ewa Breborowicz
1
· Monika Grygorowicz
2
· Marcin Dzianach
2
· Tomasz Krupecki
2
·
Lior Laver
3
· Leszek Romanowski
1
Received: 20 September 2016 / Accepted: 3 January 2017
© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2017
Both internal rotation defcits (>25°) and total arch of
motion defcit (>20°) co-existed with higher incidence of
internal impingement. Shoulder pain was common (36/97–
41%) and was associated with decreased external rotation
and total arch of motion. Internal impingement (found in
13/87–15%) correlated with decreased rotation ranges and
a greater defcit in total arch of motion, whereas higher gain
in external rotation correlated with a partial rotator cuf tear
(found in 12/87–14%).
Conclusions Shoulder pathologies and problems com-
monly afected the group of handball players. Greater
glenohumeral rotational defcits in throwing shoulders of
handball players correlate with shoulder pain and internal
impingement, while increased external rotation with par-
tial rotator cuf tears. Such defcits afect 13% of the ath-
lete population. Major clinical relevance of the study is to
monitor handball players’ shoulders both clinically and by
proper imaging. Evaluation of range of rotation seems to
identify shoulders at risk of the pathology.
Abstract
Purpose Glenohumeral range of motion adaptations may
afect throwing athletes and contribute to shoulder injury.
The purpose of this study was to evaluate shoulder rotation
defcits among elite professional handball players and its
correlation to the presence of shoulder pain and morpho-
logical changes.
Methods Eighty-seven elite professional handball players
and 41 healthy non-athlete volunteers participated in the
study. Evaluations included measurement of range of inter-
nal and external rotation, total arch of motion, identifca-
tion of shoulder pain and ultrasound scan for diagnosis of
rotator cuf tears and internal impingement.
Results Glenohumeral rotational defcits (>20–25°) were
found among 11 players group (13%). The throwing shoul-
ders in the players group showed a decrease in internal
rotation and an increase in external rotation with signif-
cantly larger ranges among players compared to the non-
athlete group. Internal rotation defcit >20° was associated
with higher incidence of shoulder pain among players.
* Przemyslaw Lubiatowski
p.lubiatowski@rehasport.pl
Piotr Kaczmarek
piotr.kaczmarek@rehasport.pl
Pawel Cisowski
pawel.cisowski@rehasport.pl
Ewa Breborowicz
ewabreborowicz@gmail.com
Monika Grygorowicz
monika.grygorowicz@rehasport.pl
Marcin Dzianach
marcin.dzianach@rehasport.pl
Tomasz Krupecki
tomasz.krupecki@rehasport.pl
Lior Laver
laver17@gmail.com
Leszek Romanowski
romanowski@data.home.pl
1
Department of Traumatology, Orthopaedics and Hand
Surgery, University of Medical Sciences in Poznan, ul. 28
Czerwca 1956r 135, 62-545 Poznań, Poland
2
Rehasport Clinic, ul. Górecka 20, 60-201 Poznań, Poland
3
Department of Orthopaediscs, University Hospital Coventry
and Warwickshire, Cliford Bridge Rd, Coventry CV2 2DX,
UK