Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
J Shoulder Elbow Surg. 2013 Jun;22(6):792-9. doi: 10.1016/j.jse.2012.07.012. Epub 2012 Sep 13.
The purpose of this study was to evaluate clinical and magnetic resonance imaging (MRI) findings in the shoulders of high performance competitive junior javelin athletes and volleyball players. The hypothesis was that structural lesions already exist in young and asymptomatic overhead athletes.
Thirty-one healthy high performance junior elite athletes were included. Group 1 consisted of 15 male javelin throwers (mean age, 17.7 ± 0.8 years) and group 2 of 16 male volleyball players (16.9 ± 1.0 years). Questionnaire-based interviews, comprehensive clinical examination, and shoulder scoring systems (visual analog scale [VAS] and Constant-Murley Score) were completed. Bilateral shoulder imaging was performed using a 3.0 Tesla MRI.
The Constant-Murley Score of group 1 was 95.5 ± 3.6 and 94.7 ± 4.6 points for group 2. Group 1 demonstrated a mean VAS of 0.9 ± 1.6 and group 2 a mean of 0.6 ± 0.8 points. Postero-superior intraosseous cysts of the humeral head were detected in 73.3% of all javelin throwers in the dominant shoulder, but only in 13.3% in the nondominant shoulder (P = .008). In the volleyball group, such cyst formation was rarely seen in 12.5% in the dominant versus 6.3% in the nondominant shoulder (P = .66).
A high percentage of junior elite athletes already demonstrate osseus signs of overloading especially in the group of javelin athletes, although none had a history of prior shoulder pathology. Therefore, junior overhead athletes might be at risk for the early development of structural lesions at the insertion of the posterior rotator cuff similar to lesions already known for adult athletes, even though they do not present clinical signs of overuse at that age.
本研究旨在评估优秀青少年竞技标枪运动员和排球运动员肩部的临床和磁共振成像（MRI）表现。假设年轻且无症状的过顶运动员已经存在结构损伤。
纳入 31 名健康的高水平青少年精英运动员。第 1 组包括 15 名男性标枪运动员（平均年龄 17.7 ± 0.8 岁），第 2 组包括 16 名男性排球运动员（16.9 ± 1.0 岁）。进行基于问卷的访谈、全面的临床检查以及肩部评分系统（视觉模拟评分[VAS]和 Constant-Murley 评分）。使用 3.0T MRI 对双侧肩部进行成像。
第 1 组的 Constant-Murley 评分为 95.5 ± 3.6 分，第 2 组为 94.7 ± 4.6 分。第 1 组的 VAS 平均为 0.9 ± 1.6 分，第 2 组为 0.6 ± 0.8 分。在所有优势肩的标枪运动员中，73.3%检测到肱骨头后上骨内囊肿，但在非优势肩仅为 13.3%（P =.008）。在排球组中，优势肩的囊肿形成率为 12.5%，而非优势肩为 6.3%（P =.66），这种情况很少见。
尽管没有既往肩部病史，但仍有很高比例的青少年精英运动员已经表现出超负荷的骨骼迹象，尤其是在标枪运动员组中。因此，青少年过顶运动员可能面临早期发展的结构性损伤，类似于已经在成年运动员中发现的肩袖后插部损伤，即使在那个年龄段他们没有表现出过度使用的临床迹象。
