Relationship between Range of Motion and Isometric Shoulder Strength in Elite Team Handball Players

BACKGROUND: The prevalence of overuse shoulder injuries is unfortunately common in team handball, potentially impacting sport participation and quality of life after players' professional careers. Shoulder rotational strength and glenohumeral range of motion have been proposed to influence the development of shoulder injuries.

PURPOSE: This study aimed to compare external and internal shoulder rotation range of motion and isometric strength among elite male and female handball players with current shoulder pain, previous shoulder pain, and no shoulder pain.

STUDY DESIGN: An explorative cross-sectional study.

METHODS: Maximal isometric shoulder internal and external rotator strength and shoulder internal and external rotation range of motion were measured and compared between sexes and among players with current shoulder pain, previous shoulder pain, and no shoulder pain. All data distributions were tested for normality with the Shapiro-Wilk test, histograms, and qq plots. An ANOVA was used to compare the internal and external shoulder range of motion and strength.

RESULTS: A total of 136 elite team handball players, 57 women (1.74±0.06 m, 72.4 ± 8.3 kg, and 22.4±4.9 years) and 79 men (1.89±0.08 m, 90.8 ± 11.8 kg, and 22.3 ± 5.2 years) participated. A significant difference in maximal internal (p<0.001) and external (p=0.004) shoulder rotator strength was found between sexes, with no significant difference in range of motion. When categorized by groups, male athletes in the no-pain group had greater internal rotator strength than males in the current and previous pain groups (p<0.042). Furthermore, female athletes in the no-pain group showed significantly less internal and external rotation range of motion compared to those playing with shoulder pain and those with previous pain.

CONCLUSION: Greater maximal isometric shoulder strength was found for men than women, primarily of the internal rotators, among all three groups. However, the men in the no-pain group had greater strength of the internal rotators than the two other groups. Range of motion was comparable between sexes, but the women without shoulder pain demonstrated significantly less internal and external rotation range of motion compared to those playing with shoulder pain and those with previous pain.

LEVEL OF EVIDENCE: 3.