International Journal of Sports Physical Therapy最新文献

{"title":"Evaluation and Treatment of Baseball Pitchers: There's More to Assess than the Arm.","authors":"Matthew L Gauthier, Casey A Unverzagt, George J Davies","doi":"10.26603/001c.127461","DOIUrl":"https://doi.org/10.26603/001c.127461","url":null,"abstract":"<p><p>Injuries are commonplace in the overhead athlete, with many occurring to the shoulder and elbow. The increasing prevalence of injuries to the shoulder and elbow has been discussed at length in recent years, with increased research focus being placed on arm care for rehabilitation and prevention strategies. Even though the pitching motion is well-established as a whole-body kinetic chain movement, most attention in rehabilitation and prevention efforts is often placed on the upper extremity. The purpose of this clinical commentary is to highlight the impact the lower extremity and trunk have on the upper extremity during the throwing motion, better equipping clinicians to treat this patient population. Additionally, this clinical commentary highlights the current literature and recommendations regarding examination of the entire kinetic chain and concludes with a review of current evidence and recommendations regarding treatment of impairments and functional limitations identified in the proximal kinetic chain. In leaving no stone unturned, clinicians can address all components of the kinetic chain in throwers, maximizing performance and mitigating risk of injury. Level of Evidence: 5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 1","pages":"113-126"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Medial Meniscus Root Tears: Clinical Implications, Surgical Management, and Post-operative Rehabilitation Considerations.","authors":"Jill K Monson, Robert F LaPrade","doi":"10.26603/001c.126967","DOIUrl":"https://doi.org/10.26603/001c.126967","url":null,"abstract":"<p><p>Tears of the posterior medial meniscus root (PMMR) are common in older patients and reportedly contribute to rapid joint degeneration over time. Recognition of these tear types and the appropriate diagnosis through clinical exam and diagnostic imaging have improved significantly in recent years, as have surgical techniques to address them. Standardized post-operative rehabilitation protocols specific to PMMR repair have not been established or well understood in the scientific literature. Thus, clinicians have little guidance for managing post-operative care. Upon diagnosis of a root tear, appropriate surgical treatment, with appreciation for native anatomy and function of the meniscus root, is a critical first step for recovery. Post-operative rehabilitation protocols should account for biomechanical considerations unique to root tears, because they can destabilize the entire meniscus and compromise its native function. Rehabilitation specialists can apply known science regarding the influence of joint motion, muscle strengthening activities, gait, squatting, and progressive loading activities on the healing meniscus to guide post-operative recovery. This knowledge, complemented with existing foundational principles for sound post-operative rehabilitation, can optimize recovery for patients following PMMR repair. The purpose of this clinical commentary is to explore clinical questions related to 1) PMMR injury epidemiology, 2) diagnosis and surgical management of PMMR tears, and 3) critical considerations for safe and effective post-operative rehabilitation. Level of Evidence: 5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 1","pages":"127-136"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Foam Roller Warm-Up in Professional Basketball Players: A Randomized Controlled Trial.","authors":"Daniel Casado, Ivan Nacher, Juan Pardo, Javier Reina","doi":"10.26603/001c.127266","DOIUrl":"https://doi.org/10.26603/001c.127266","url":null,"abstract":"<p><strong>Background: </strong>The foam roller is considered a versatile tool. Along with an active warm-up, it appears to positively affect range of motion, stability, muscle stiffness, and perceived exertion with no reductions in performance.</p><p><strong>Hypothesis/purpose: </strong>The main purpose of the study was to observe the effects of the utilization of a foam roller during the warm-up on ankle mobility and lower limb stability, and secondarily, to assess if any induced effects were sustained over time.</p><p><strong>Study design: </strong>Randomized controlled trial.</p><p><strong>Methods: </strong>Twenty-two healthy male subjects were randomly assigned to two groups: the control group, which only carried out a general warm-up over a period of four months, and the foam roller group, which followed a specific warm-up routine using a foam roller for a period of three months plus one month of follow-up in which no foam rolling was performed. Two outcome measurements were taken pre- and post- intervention to assess ankle mobility: the Dorsi-Flexion Lunge test and the Y-Balance test (YBT) for the lower quarter. Outcomes were measured at three time points: before the protocol was initiated, at the end of the protocol (at 12 weeks), and after a one-month follow-up period (at 16 weeks).</p><p><strong>Results: </strong>A significant increase was observed in the dorsiflexion of the right (p < 0.001) and left (p < 0.001) ankles in the experimental group. Significant increases were also noticed in the anterior (p < 0.003), posteromedial (p < 0.050), and posterolateral (p < 0.050) reach distances of the right leg and in the anterior (p < 0.002), posteromedial (p < 0.010), and posterolateral (p < 0.030) reach distances of the left leg during the YBT in the experimental group. The control group also showed significant differences in the right (p < 0.007) and left (p < 0.010) anterior reach distances on the YBT. At the one-month follow-up period, the improvements that had been obtained in both groups were lost, except for the dorsiflexion of the right ankle (p < 0.050) and right (p < 0.010) and left (p < 0.030) anterior reach distance on the YBT in the experimental group.</p><p><strong>Conclusions: </strong>The foam roller can be used as a part of a pre-training warm-up routine to enhance the dorsiflexion range of motion and performance on the YBT.</p><p><strong>Level of evidence: </strong>3. Registered as a clinical trial at ClinicalTrials.gov with registration number: NCT05971316.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 1","pages":"15-29"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Kettlebell Swing Style and Mass on Female Hip Joint Kinetics.","authors":"Kasey M Murphy, Bryan L Riemann","doi":"10.26603/001c.127464","DOIUrl":"https://doi.org/10.26603/001c.127464","url":null,"abstract":"<p><strong>Background: </strong>Kettlebell (KB) swing exercises, whether performed using shoulder height (SHS) or overhead (OHS) swing variations in therapeutic or strength and conditioning settings, are posterior chain dominant exercises that require hip extension contributions when performed correctly.</p><p><strong>Purpose/ hypothesis: </strong>The primary purpose of this study was to evaluate the effect of swing style (SHS, OHS) and KB mass on hip extension kinematics and kinetics in young adult females. A secondary purpose was to determine the effects of swing style and KB mass on the forces applied to the total body center of mass and KB. It was hypothesized that velocity, power, and work would be greater for the OHS compared to the SHS, as well as for the heavier compared to the lighter KB's.</p><p><strong>Study design: </strong>Crossover study design.</p><p><strong>Methods: </strong>Fifteen physically active females performed 15 swings under four conditions, SHS/12kg, SHS/16kg, OHS/12kg, and OHS/16kg, while three-dimensional dominant limb foot, shank, thigh, pelvis, and KB kinematic and ground reaction force (GRF) data were collected.</p><p><strong>Results: </strong>KB distance (95%CIDiff: 17.5-25.1 %BH), time (95%CIDiff: 0.067-0.023 s), and peak velocity (95%CIDiff: 0.56-0.74 m‧s-1) were significantly greater during the OHS (p<0.05). During OHS, significantly greater hip joint peak power (95%CIDiff: 1.6-4.1 W‧kg-1), work (95%CIDiff: 0.104-0.527), peak velocity (95%CIDiff: 7.6-40.5 °‧s-1) occurred compared to SHS, although the time and hip angular position of peak velocity and peak power were not statistically different between styles.</p><p><strong>Conclusions: </strong>These results may influence choices of KB progressions, suggesting that one may first consider changes in KB mass prior to changing from the SHS style to the OHS style.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"20 1","pages":"30-39"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Diagnostic Musculoskeletal Ultrasound for the Evaluation of the Iliopsoas in the Anterior Hip: A Guide for Rehabilitation Providers.","authors":"Robert C Manske, Michael Voight, Chris Wolfe, Phil Page, Beth Bardowski","doi":"10.26603/001c.126334","DOIUrl":"10.26603/001c.126334","url":null,"abstract":"<p><p>Musculoskeletal ultrasound (MSK-US) has become an increasingly valuable tool in the evaluation and management of soft tissue and joint pathologies, particularly for rehabilitation providers. This article highlights the use of MSK-US for assessing the iliopsoas tendon and musculature in the anterior hip. The iliopsoas complex is often implicated in conditions such as tendinitis, snapping hip syndrome, and hip flexor strains, and accurate assessment can be challenging due to its deep anatomical location. MSK-US offers a safe, cost-effective, and dynamic modality for visualizing the iliopsoas, providing crucial insights into its morphology, pathology, and response to rehabilitation interventions. This paper discusses the anatomy of the iliopsoas, ultrasound scanning techniques, common findings, and the clinical relevance of MSK-US in rehabilitation settings. This paper explores the efficacy of MSK-US in the assessment of the iliopsoas muscle and tendon and underscores its utility in diagnosing iliopsoas-related abnormalities such as tendinopathy and bursitis.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 12","pages":"1642-1646"},"PeriodicalIF":1.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction of the 'Blue Card' Concussion Policy to Semi-Elite Australian Football: Medical Staff Experiences and Perceptions.","authors":"Jacob R Msando, Gill Cowen, Sarah A Harris, Troy Kirkham, Myles C Murphy","doi":"10.26603/001c.125794","DOIUrl":"10.26603/001c.125794","url":null,"abstract":"<p><strong>Background: </strong>The Western Australian Football League (WAFL) introduced a new umpire driven 'blue-card rule' for concussion, but its benefit to the sports medicine team is unknown.</p><p><strong>Purpose: </strong>To determine the experiences and perceptions of medical staff within the 2022-2023 Men's and Women's WAFL competitions following the introduction of the 'blue-card rule'.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Method: </strong>An online survey was delivered through Qualtrics to all WAFL medical staff (doctors, physiotherapists, head trainers). The survey contained four sections (demographics, concussion knowledge, concussion exposure and blue-card perceptions) with closed and multiple-answer questions. Standard methods for reporting descriptive data were applied, including mean ± standard deviation (SD) and proportions (%). Between-group differences were assessed using chi-square tests, and significance was accepted at p <0.05.</p><p><strong>Results: </strong>Response rate was 48% (n=7 doctors, n=12 physiotherapists, n=12 head trainers). Most staff (70%) did not agree that the 'blue-card rule' was a helpful concussion policy or should remain within the WAFL. Staff also felt umpires are not qualified to identify suspected concussions on-field (67%). Over two-thirds of medical staff feel the Football Commission needs to provide education about concussion policies before the commencement of each season. Only 33% of medical staff felt completely confident in delivering a sideline assessment, and 17% felt completely confident in their diagnostic capabilities. Relationships between medical and other staff were not substantially impacted by the 'blue-card rule'.</p><p><strong>Conclusions: </strong>Medical staff within the WAFL reported the 'blue-card rule' as an ineffective concussion identification tool and did not support its continued use for future WAFL seasons. Staff suggested that the Football Commission needs to provide more education on concussion policies before the commencement of each season.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 12","pages":"1569-1580"},"PeriodicalIF":1.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurocognitive and Neuromuscular Rehabilitation Techniques after ACL injury - Part 2: Maximizing Performance in the Advanced Return to Sport Phase.","authors":"Zachary M Thomas, Lewis Lupowitz, Morgan Ivey, Kevin E Wilk","doi":"10.26603/001c.126270","DOIUrl":"10.26603/001c.126270","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) injury and reinjury rates are on the rise, despite improved surgical techniques and prevention programs. ACL injuries also lead to a variety of neuroplastic and neuromuscular alterations. Emerging research highlights the importance of addressing neurocognitive deficits that can persist after injury including altered proprioception, impaired motor control, muscle recruitment and heightened reliance on visual feedback. This suggests a shift from subconscious movement, to movements that require increased volitional control, which may contribute to increased risk of re-injury and thus impede return to sport.</p><p><strong>Clinical question: </strong>Given the neurophysiological changes associated with anterior cruciate ligament (ACL) injury that persistent into the late stages of rehabilitation, does the integration of neurocognitive training into mid to late stage rehabilitation protocols improve functional outcomes and reduce the risk of re-injury following ACL reconstruction (ACLR) in athletes?</p><p><strong>Purpose: </strong>The purpose of Part 2 of this clinical commentary is to offer strategies to implement neurocognitive training elements into the traditional ACLR rehabilitation (in weeks 9+) and review updated testing metrics that may better discern an athletes readiness to return to competition. A comprehensive rehabilitation framework incorporating both physical and neurocognitive components is proposed, aiming to improve both long-term outcomes and return to sport testing, as well as diminishing re-injury risk.</p><p><strong>Conclusion: </strong>Updates to the traditional rehabilitation approach post ACLR, that include increased emphasis on neuroplastic, cognitive, and visual-motor capabilities exist. These help prepare athletes for the unpredictable and chaotic nature of the sporting environment and may facilitate a more effective return to sport for athletes, potentially mitigating the risk of re-injury.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 12","pages":"1629-1641"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Shoulder Pain, Trunk and Lower Limb Pain in Overhead Athletes: A Systematic Review with Meta-analysis.","authors":"Marine Leroux, Franck Lagniaux","doi":"10.26603/001c.125882","DOIUrl":"10.26603/001c.125882","url":null,"abstract":"<p><strong>Background: </strong>Forty-nine percent of overhead athletes suffer from shoulder pain. Throwing movements require the participation of all components of the kinetic chain to reduce risk for shoulder overuse. Thus, limited lower limb range of motion or weakness has been identified as a risk factor for shoulder pain in overhead athletes.</p><p><strong>Purpose: </strong>This systematic review aims to evaluate the association between shoulder, trunk, and lower limb pain in overhead athletes.</p><p><strong>Study design: </strong>Systematic Review and Meta-analysis.</p><p><strong>Methods: </strong>A systematic review was conducted in the PubMed/MEDLINE, Science Direct and CENTRAL/Cochrane databases for observational studies. Search terms included sports-related terms (e.g., 'overhead', 'baseball', 'volleyball', 'handball') and injury-related terms (e.g., 'injury history', 'shoulder pain', 'lower limb pain', 'hip pain', 'knee pain', 'ankle pain', 'foot pain', 'trunk pain'). Studies were considered for review if they met the following criteria: inclusion of overhead athletes, investigation of injury or pain in shoulder and lower limb or trunk, had data related to or could calculate the calculation of odds ratio (OR) or relative risk (RR), available in French or English. The ROBINS-E tool was used to assess the methodological quality of each article. The data were pooled in a random-effects meta-analysis, using odds ratios to estimate the strength of the association between shoulder pain and pain at other locations.</p><p><strong>Results: </strong>Seven articles were included. Five of them were at moderate risk of bias and two were at high risk of bias. Shoulder pain was associated with low back pain (OR=5.51), hip pain (OR=4.32), knee pain (OR=3.03) and ankle/foot pain (OR=2.84).</p><p><strong>Conclusion: </strong>This systematic review highlighted, with very low to low certainty, a significant association between shoulder pain and trunk/lower limb pain or injuries.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 12","pages":"1509-1520"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient-Physiotherapist Tango: a Personalized Approach to ACL Recovery - a Qualitative Interview Study.","authors":"Ramana Piussi, Ella Brandt, Alicia Johansson, Thorkell Snaebjörnsson, Roland Thomeé, Kristian Samuelsson, Eric Hamrin Senorski","doi":"10.26603/001c.126060","DOIUrl":"10.26603/001c.126060","url":null,"abstract":"<p><strong>Background: </strong>Person-centered care is a concept in healthcare that aims to promote the patient's health and adapt resources and interventions based on the patient's needs and wishes. Knowledge on what person-centered physiotherapy is for patients who rehabilitate after an anterior cruciate ligament (ACL) reconstruction, and how patients experience it within the context of sports injury rehabilitation, is lacking.</p><p><strong>Purpose: </strong>The aim of this study was to explore how patients who were in a late rehabilitation stage (8-12 months) after ACL reconstruction experienced their rehabilitation from a person-centered perspective.</p><p><strong>Study design: </strong>Qualitative interview study.</p><p><strong>Methods: </strong>Fourteen patients (57% females), aged 18-57, treated with ACL reconstruction, were interviewed with semi-structured interviews 8-12 months after ACL reconstruction. Interviews were recorded, transcribed and analyzed with qualitative content analysis.</p><p><strong>Results: </strong>One theme: all lights on me; be seen and heard, a cornerstone for patients, supported by three main categories: 1) rehabilitation: a roller coaster of physical and psychological challenges; 2) patient involvement; 3) the physiotherapist - stronger together; emerged from the collected data.</p><p><strong>Conclusion: </strong>Patients in a late rehabilitation stage (8-12 months) after ACL reconstruction experienced that the rehabilitation process was person-centered when they felt to be the focus and were allowed to participate via open and constructive communication with the physiotherapists.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 12","pages":"1589-1599"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Let´s Swing it -The Interaction Between Participation-Related Shoulder Load and Pre-season Trunk Rotation Power on Shoulder Problems in Male Handball Players.","authors":"Kari Arnason, Atli Agustsson, Hilde Fredriksen, Elis Thor Rafnsson, Kristin Briem","doi":"10.26603/001c.126187","DOIUrl":"10.26603/001c.126187","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the influence of kinetic chain strength and power on shoulder problems in handball players or the impact of participation-related shoulder load (PSL) during a season. Suboptimal activity of the kinetic chain during throwing might make the shoulder more vulnerable.</p><p><strong>Purpose: </strong>The purpose of this study was to assess 1) the association between pre-season measurements and shoulder problems among handball players and 2) whether pre-season strength and power influence the association between PSL and severity of shoulder problems.</p><p><strong>Study design: </strong>Prospective observational cohort study.</p><p><strong>Methods: </strong>Pre-season measurements were done using the Isometric mid-thigh pull for lower body strength, a seated test for trunk rotation power (TRP) and isometric testing of external (ER) and internal rotation shoulder strength on 42 male players. Shoulder problems (prevalence, substantial prevalence, and severity score) were documented weekly through a season (31 weeks) with The Oslo Sports Trauma Research Center Overuse Questionnaire (OSTRC-O2) and PSL with the modified Borg rate of perceived exertion scale. Spearman´s correlation coefficient was applied to examine the association within the first aim, while a mixed model ANOVA was conducted to analyze the second aim.</p><p><strong>Results: </strong>A weak and negative correlation (rs=-0.34) was found between pre-season ER strength and the individual prevalence of shoulder problems (p=0.029). A main effect was found between PSL and the OSTRC-O2 severity score (p=<0.001) with higher severity scores observed with increased PSL. A significant interaction was found between PSL and pre-season TRP regarding their influence on the OSTRC-02 severity score (p=0.017). With higher PSL, a higher severity score was observed among players with pre-season TRP more than one standard deviation below the group's mean.</p><p><strong>Conclusions: </strong>The results indicate that low TRP may make the throwing shoulder more vulnerable to an increase in load. Looking beyond shoulder strength and load may therefore be important.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":47892,"journal":{"name":"International Journal of Sports Physical Therapy","volume":"19 12","pages":"1541-1550"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}