The throwing shoulder in youth elite handball: soft-tissue adaptations but not humeral retrotorsion differ between the two sexes

Knee Surg Sports Traumatol Arthrosc. 2019 Dec;27(12):3937-3943. doi: 10.1007/s00167-019-05578-0. Epub 2019 Jun 26.

Abstract

Purpose: In youth handball players, knowledge about the development of soft-tissue adaptation and humeral retrotorsion is limited. The purpose of this study was to investigate differences in adaptations in the glenohumeral rotational range of motion and humeral retrotorsion of the throwing arm between male and female youth elite handball players.

Methods: One-hundred and thirty-eight youth elite handball players (mean age: 14.1 ± 0.7 years) were assessed for glenohumeral external (ER) and internal (IR) rotational ranges of motion and humeral retrotorsion (HRT) by means of a manual goniometer and a portable ultrasound device. Sports-specific adaptations between the dominant and non-dominant shoulders and between male and female adolescents were calculated.

Results: Handball players showed side-to-side differences in IR and ER in the throwing shoulder. HRT did not correlate with the measurements of rotational ROM of the throwing arm. Male athletes showed a more pronounced glenohumeral internal rotation deficit than female athletes (13.1° ± 22.8° vs. 5.1° ± 14.0°, p = 0.014). Adaptations in HRT but no sex differences could be seen in the throwing shoulder (16.5° ± 9.6°) compared to the non-throwing shoulder (13.5° ± 9.4°, p < 0.001).

Conclusion: Loss of internal rotation and gain in external rotation in youth handball players seem to be more related to adaptive changes in the soft-tissues than to HRT. Male athletes showed stronger throwing-related adaptations in the rotational range of motion but not in humeral torsion in their dominant shoulder than female athletes.

Level of evidence: Cross-sectional study, Level II.

Keywords: Adolescent; Injury; Overhead; Overuse; Range of motion.

MeSH terms

  • Adaptation, Physiological*
  • Adolescent
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Range of Motion, Articular / physiology*
  • Rotation
  • Sex Factors
  • Shoulder Joint / diagnostic imaging*
  • Shoulder Joint / physiology*
  • Sports / physiology*
  • Ultrasonography