女子手球运动员肩部内外负荷、季前力量和爆发力与肩部问题之间的关联
The Association Between Internal and External Shoulder Load, Pre-season Strength and Power, with Shoulder Problems in Female Handball Players.
作者信息
Arnason Kari, Asgeirsdottir Erla, Arnarsson Unnar, Agustsson Atli, Briem Kristin
机构信息
Department of physical therapy - Research centre of rehabilitation and movement science University of Iceland.
出版信息
Int J Sports Phys Ther. 2025 Aug 1;20(8):1203-1213. doi: 10.26603/001c.142239. eCollection 2025.
BACKGROUND
Injuries often result from an interaction between load and intrinsic risk factors, with female handball players demonstrating higher prevalence of shoulder problems compared to males. While shoulder rotation strength deficits are recognized as risk factors, the influence of lower body strength (LBS), trunk rotation power (TRP), and the relative importance of internal versus external load on shoulder problems in female handball players remains unknown.
PURPOSE
To assess whether pre-season LBS, TRP, and shoulder strength were associated with shoulder problems in female handball players, and whether pre-season strength and power influenced the association between load and shoulder problems.
STUDY DESIGN
Prospective observational cohort study.
METHODS
Pre-season LBS (Isometric Mid-thigh Pull), TRP (measured while seated) and isometric external (ER) and internal rotation (IR) shoulder strength were measured (31 female handball players). Prevalence, substantial prevalence, and severity of shoulder problems were documented weekly through one season (29 weeks) via the Oslo Sports Trauma Research Center Overuse Questionnaire. Participation-related (internal) shoulder load (PSL) was documented weekly with the modified Borg rate of perceived exertion and the number of shots taken during the season documented to reflect external load. Data was analyzed using the Spearman´s correlation coefficient and a mixed model ANOVA (separate mixed model ANOVAs were constructed for each pre-season variable).
RESULTS
Thirty-one players (mean age 23.5 +/- 4.6 years) participated. For all mixed model ANOVAs, higher PSL was associated with higher severity score (F range: 31.1-39.9, p<0.001). Significant positive interactions were found between PSL and pre-season TRP (p=0.001), LBS (p<0.001), and ER strength (p=0.01) in terms of their influence on the severity score. High pre-season LBS and ER strength were correlated with prevalence of substantial shoulder problems (r=0.40, r=0.38, respectively).
CONCLUSIONS
The positive association between pre-season strength and power, and shoulder problems, highlights the complexity of shoulder problems in female handball players.
LEVEL OF EVIDENCE
背景
损伤通常是由负荷与内在风险因素相互作用导致的，与男性相比，女性手球运动员肩部问题的患病率更高。虽然肩部旋转力量不足被认为是风险因素，但下身力量（LBS）、躯干旋转力量（TRP）以及内在负荷与外在负荷对女性手球运动员肩部问题的相对重要性仍不明确。
目的
评估季前LBS、TRP和肩部力量是否与女性手球运动员的肩部问题相关，以及季前力量和力量是否会影响负荷与肩部问题之间的关联。
研究设计
前瞻性观察队列研究。
方法
测量了31名女性手球运动员的季前LBS（等长中大腿拉伸）、TRP（坐姿测量）以及等长外旋（ER）和内旋（IR）肩部力量。通过奥斯陆运动创伤研究中心过度使用问卷，在一个赛季（29周）内每周记录肩部问题的患病率、显著患病率和严重程度。每周用改良的博格自觉用力等级记录与参与相关的（内在）肩部负荷（PSL），并记录赛季中投篮次数以反映外在负荷。使用斯皮尔曼相关系数和混合模型方差分析（针对每个季前变量构建单独的混合模型方差分析）对数据进行分析。
结果
31名运动员（平均年龄23.5±4.6岁）参与了研究。对于所有混合模型方差分析，较高的PSL与较高的严重程度评分相关（F范围：31.1 - 39.9，p<0.001）。在对严重程度评分的影响方面，发现PSL与季前TRP（p = 0.001）、LBS（p<0.001）和ER力量（p = 0.01）之间存在显著的正交互作用。季前高LBS和ER力量与严重肩部问题的患病率相关（分别为r = 0.40，r = 0.38）。
结论
季前力量和力量与肩部问题之间的正相关突出了女性手球运动员肩部问题的复杂性。
证据水平
3级。
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