Preseason Strength Assessment of the Rotator Muscles and Shoulder Injury in Handball Players

J Athl Train. 2018 Feb;53(2):174-180. doi: 10.4085/1062-6050-216-16. Epub 2018 Jan 17.


Context: Few researchers have identified intrinsic risk factors for shoulder injury in team handball players by analyzing measurements of maximal isokinetic rotator muscle strength.

Objective: To identify possible intrinsic risk factors for shoulder injury by analyzing measurements of maximal isokinetic rotator muscle strength.

Design: Cross-sectional study.

Setting: Male team handball senior divisions (the highest level) in France and Belgium.

Patients or other participants: A total of 108 male high-level handball players (age = 24 ± 4 years, height = 189 ± 6 cm, mass = 87 ± 11 kg) were enrolled.

Main outcome measure(s): All players completed a preseason questionnaire and performed a bilateral isokinetic assessment of the shoulder rotator muscles. On a monthly questionnaire, players reported any shoulder injury that they sustained during the season.

Results: On the preseason questionnaire, 51 of 108 (47%) participants reported a history of dominant-shoulder injury. A total of 106 participants completed the in-season questionnaire, with 22% (n = 23) reporting a shoulder injury on their dominant side during the subsequent season. Fourteen percent (n = 15) sustained microtraumatic injuries, and 8% (n = 8) described a traumatic injury. Backcourt players had a 3.5-times increased risk of injury during the new season compared with players in other positions. Among the isokinetic results, no risk factor for further injury was identified in handball players with microtraumatic injuries. For traumatic injuries, the concentric maximal strength developed by the internal rotators at high speed (240°/s) in the dominant shoulder was a protective factor against the risk of further injury.

Conclusions: These results can potentially identify intrinsic risk factors for shoulder injury and may be used to determine potential interventions for reducing this risk in handball players.

Keywords: isokinetic strength; prospective study; risk factors; rotator cuff weakness.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Muscle Strength
  • Risk Assessment
  • Risk Factors
  • Rotation / adverse effects
  • Rotator Cuff* / physiology
  • Rotator Cuff* / physiopathology
  • Shoulder Injuries* / diagnosis
  • Shoulder Injuries* / etiology
  • Shoulder Injuries* / physiopathology
  • Shoulder Joint* / physiology
  • Shoulder Joint* / physiopathology
  • Volleyball* / injuries
  • Volleyball* / physiology