  Citation: Daneshjoo, A.; Hoseinpour, A.; Sadeghi, H.; Kalantari, A.; Behm, D.G. The Effect of a Handball Warm-Up Program on Dynamic Balance among Elite Adolescent Handball Players. Sports 2022, 10, 18. https://doi.org/10.3390/ sports10020018 Academic Editor: Pedro E. Alcaraz Received: 16 December 2021 Accepted: 28 January 2022 Published: 31 January 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). sports Article The Effect of a Handball Warm-Up Program on Dynamic Balance among Elite Adolescent Handball Players Abdolhamid Daneshjoo 1,2 , Ali Hoseinpour 1 , Hassan Sadeghi 3 , Aref Kalantari 1 and David George Behm 2, * 1 Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Shahid Bahonar University of Kerman, Kerman 76169-13439, Iran; daneshjoo.hamid@uk.ac.ir (A.D.); hosseinpour70@yahoo.com (A.H.); aref07kalantari@gmail.com (A.K.) 2 School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada 3 Department of Biomechanics and Sport Injuries, Faculty of Physical Education and Sport Sciences, Kharazmi University, Tehran 15719-14911, Iran; hasan.sadeghi81@gmail.com * Correspondence: dbehm@mun.ca Abstract: This study examined the effect of the handball warm-up program (HWP) on dynamic balance among elite adolescent handball players. In this case, 24 handball players were randomly assigned into experimental warm-up and control groups. The HWP was performed over 8 weeks (3 times per week). Dynamic balance before and after the intervention training programs were measured by the Biodex Balance System (BBS) and Y Balance test for the dominant (DL) and non- dominant legs (non-DL). After HWP training, BBS scores significantly improved in the overall (OSI) (30.4% and 31.1%), anterior-posterior (APSI) (44.6% and 35.2%), and medial-lateral stability indexes (MLSI) (38.8% and 43%) for both DL and non-DL. Post-training, the Y Balance test exhibited significant improvements in OSI (13.2% and 10.6%), anterior (17.2% and 12.6%), posteriolateral (12.8% and 11.3%), and posteriomedial stability indexes (9.2% and 7.9%) with DL and non-DL, respectively. In conclusion, dynamic balance improved overall after eight weeks of the HWP, with this improvement significantly greater with the trained versus the control group. Optimal balance during handball is an important factor to ensure coordinated and efficient movements and it is speculated that improved balance could positively impact injury prevention. Hence, the HWP program can be used as an alternative to a conventional warm-up program. Keywords: equilibrium; postural balance; risk factors; stability; instability 1. Introduction Handball commenced in 1946 and is presently composed of almost 170 members of the International Handball Federation including 795,000 handball teams and an estimated 25 million players worldwide [1]. It is a dynamic and physically demanding sport, mainly because of the intensive body contact between the players. The necessity for high levels of agility, strength, and balance imposes a high demand on the musculoskeletal system. Handball is reported to sustain the highest relative incidence of sports injuries [2]. Injuries in team handball are common and result in high costs for the players, club, and public health system and may even cause long-term disability for the injured player [3]. The injury rate in youth handball players has been shown to be between 9.9 and 41.0 injuries per 1000 match h and between 0.9 and 2.6 injuries per 1000 training h [4]. Non-contact injuries are highly prevalent (68.5%) among male junior handball players (16 years old) [5]. In order to protect the players, an injury prevention program is an urgent need [2]. Unfortunately, there are only a few recent studies on the injury prevention with male handball players. It is reported that a multifaceted intervention program with an appropriate warm-up structure has been effective at enhancing the performance and preventing common injuries among players, especially soccer players [6–8]. Sports 2022, 10, 18. https://doi.org/10.3390/sports10020018 https://www.mdpi.com/journal/sports