力量是肩部过度使用损伤的主要风险因素吗？一项对296名业余上肢运动员的队列研究。
Is Strength the Main Risk Factor of Overuse Shoulder Injuries? A Cohort Study of 296 Amateur Overhead Athletes.
作者信息
Intelangelo Leonardo, Lassaga Ignacio, Gonzalo Elias, Mendoza Cristian, Manuel Ormazabal Juan, Roulet Iván, Bevacqua Nicolás, Jerez-Mayorga Daniel
机构信息
Musculoskeletal Research Unit, University Center for Assistance, Teaching and Research, University of Gran Rosario, Rosario, Argentina.
Faculty of Rehabilitation Sciences, Universidad Andres Bello, Las Condes, Santiago de Chile, Chile, and Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.
出版信息
Sports Health. 2024 Dec 23:19417381241298287. doi: 10.1177/19417381241298287.
BACKGROUND
Shoulder pain is one of the most common musculoskeletal complaints in overhead athletes. This study investigated the prevalence of the main risk factors and sex differences related to the development of shoulder pain in a cohort of amateur overhead athletes.
HYPOTHESIS
The external rotation/internal rotation (ER/IR) isometric strength ratio <0.75% is the most prevalent risk factor associated to overuse shoulder injuries in both sexes.
STUDY DESIGN
Cohort study.
LEVEL OF EVIDENCE
Level 3.
METHODS
A total of 296 (147 male and 149 female) amateur overhead athletes from handball, volleyball, and water polo participated in this cross-sectional study. Isometric strength, rotational range of motion, and scapular control were analyzed bilaterally. The measurements and motions were randomized between sides.
RESULTS
The ER/IR isometric strength ratio deficit among the disciplines was presented in 264 and 229 out of 296 athletes in the dominant and nondominant sides, respectively. Normalized isometric strength showed significant differences for dominant ( < 0.01; ε² = 0.47) and nondominant IR ( < 0.01; ε² = 0.60). No significant differences were observed between dominant ( = 0.44; ε² = 0.05) and nondominant ER ( = -0.24; ε² = 0.07). The prevalence of glenohumeral IR deficit (GIRD) ( = 0.81) and total arc of motion differences (TAMD) ( = 0.39) was low, with no difference between sexes. Male (16.3%) and female (12.1%) athletes had low rate of obvious scapular dyskinesis in their dominant shoulders.
CONCLUSION
Muscle strength was the most prevalent risk factor. The ER/IR ratio imbalance was present in both sides, without sex differences. Risk factors such as scapular dyskinesis, GIRD, and TAMD were present in low percentages, without sex differences.
CLINICAL RELEVANCE
It is advisable to implement shoulder exercises to strengthen ER muscles to decrease differences between internal and external rotators and prevent injuries in overhead athletes.
背景
肩部疼痛是从事过头运动的运动员中最常见的肌肉骨骼问题之一。本研究调查了一组业余过头运动运动员中与肩部疼痛发生相关的主要风险因素的患病率及性别差异。
假设
外旋/内旋（ER/IR）等长肌力比值<0.75%是两性中与肩部过度使用损伤相关的最普遍风险因素。
研究设计
队列研究。
证据水平
3级。
方法
共有296名（147名男性和149名女性）来自手球、排球和水球项目的业余过头运动运动员参与了这项横断面研究。对双侧的等长肌力、旋转活动范围和肩胛控制进行了分析。测量和动作在两侧之间随机进行。
结果
在296名运动员中，优势侧和非优势侧分别有264名和229名存在各项目中的ER/IR等长肌力比值不足。标准化等长肌力在优势侧内旋（<0.01；ε² = 0.47）和非优势侧内旋（<0.01；ε² = 0.60）方面显示出显著差异。在优势侧外旋（= 0.44；ε² = 0.05）和非优势侧外旋（= -0.24；ε² = 0.07）之间未观察到显著差异。盂肱关节内旋不足（GIRD）（= 0.81）和总活动弧差异（TAMD）（= 0.39）的患病率较低，两性之间无差异。男性（16.3%）和女性（12.1%）运动员优势肩的明显肩胛运动障碍发生率较低。
结论
肌肉力量是最普遍的风险因素。ER/IR比值失衡在两侧均存在，无性别差异。肩胛运动障碍、GIRD和TAMD等风险因素的发生率较低，无性别差异。
临床意义
建议进行肩部锻炼以增强外旋肌，减少内、外旋肌之间的差异，预防过头运动运动员受伤。
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