No relationship between a movement screening test and risk of overuse problems in low back, shoulder, and knee in elite handball players—A prospective cohort study

Abstract

Many handball studies have reported injuries that cause absence from participation. In this prospective cohort study on elite Icelandic male players, the aim was to examine the prevalence of overuse problems in low back, knee, and shoulder. Sixteen Icelandic teams were invited. Thirteen teams agreed to participate. The OSTRC overuse questionnaire was distributed every second week during 32‐week period. In addition, the 9+ Screening Test was performed on 130 players. In total, 229 players participated with a weekly average response rate of 72%. The average weekly prevalence for shoulder was 28% (95% CI 25% to 31%), for knee 33% (95% CI 30% to 36%), and for low back 32% (95% CI 29% to 35%). Substantial problems were 10% (95% CI 9% to 11%) in shoulder and knee and 11% (95%CI 10% to 12%) in low back. Only 1% (95% CI 1% to 2%) of the overuse problems caused time loss from participation. In total, 61% of the players played with at least one overuse problem and 25% with one affecting their performance. There was no association between the 9+ Screening Test score and overuse problems among Icelandic male handball players.

Association between training load, intensity, and overuse problems during pre‐season in Icelandic male handball

“…Though, it should be noted that the research populations differ regarding age, gender and level of play 26‐28,32 . The prevalence is in line with results from a competitive season in Icelandic elite male handball, 23 except in low back, where the SOP prevalence was higher in the competitive season (11% vs. 6%) and in OP in shoulder where the prevalence in the current study was higher (40% vs. 28%). Considering the difference in prevalence of low back problems between pre‐season and competitive season, one reason might be that most of the players are without SOP in low back following a summer break without a training schedule.…”

“…Players were asked to report on any OP in the shoulder, low back, or knee during the previous week. For each anatomical area, players answered four questions to report on possible consequences of OP, on the player's participation, training volume, performance, and extent of pain 23,29 . Although the questions asked were related to OP, the team physical therapists registered and identified injury types.…”

“…SOP were defined if players reported moderate or severe reductions in participation or training volume. Time‐loss overuse problems (TLOP) were defined if players reported the maximum value in at least one of the first three questions in the questionnaire 23 . As recommended by Clarsen et al (2013), the data from the first questionnaire, covering the first week of the pre‐season, were removed from all analyses due to high response rate.…”

“…The Oslo Sports Trauma Research Center (OSTRC) 22 overuse injury questionnaire was designed to meet these demands. The registration model has been used on various sports 23,24 revealing unidentified data on injuries 23,24 and health‐related problems 25 . Studies on handball players have shown that the prevalence of all reported OP was 14%‐33% in knees, 23,24,26 12%‐32% in low back, 23,24,26 and 17%‐32% in shoulders 23,24,26‐28 .…”

“…The registration model has been used on various sports 23,24 revealing unidentified data on injuries 23,24 and health‐related problems 25 . Studies on handball players have shown that the prevalence of all reported OP was 14%‐33% in knees, 23,24,26 12%‐32% in low back, 23,24,26 and 17%‐32% in shoulders 23,24,26‐28 . The prevalence of substantial overuse problems (SOP), affecting players performance or participation, was 5%‐11% in knees, 23,24,26 2%‐11% in low back, 23,24,26 and 5%‐15% in shoulders 23,24,26‐28 …”