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Hintergrund: Handball wird als eine der verletzungsanfälligsten Mannschaftssportarten überhaupt bezeichnet und die Schulter stellt dabei das vierthäufigste betroffene Gelenk dar. Die Mehrheit dieser Verletzungen sind auf chronische Überbelastungen zurückzuführen. Zur Entwicklung von Präventions- und Rehabilitationsprogrammen ist es essenziell, die Risikofaktoren solcher Verletzungen zu kennen. Ziel: Den Zusammenhang zwischen Skapuladyskinesie, signifikanten Unterschieden des glenohumeralen Bewegungsausmasses im Seitenvergleich, sowie einem muskulären Missverhältnis der Aussenrotatorenkraft zur Innenrotatorenkraft und dem Risiko für nichttraumatische Schulterverletzungen zu eruieren. Methodik: Anhand einer systematischen Literaturrecherche in den Datenbanken PubMed, SportDiscus und CINAHL wurden vier relevante Studien identifiziert und anhand des Arbeitsinstruments Critical Appraisal der Zürcher Hochschule für Angewandte Wissenschaften kritisch gewürdigt. Ergebnisse: Drei der vier Studien erhoben einen signifikanten Zusammenhang zwischen einer reduzierten Aussenrotationskraft sowie Veränderungen des glenohumeralen Bewegungsausmasses im Seitenvergleich und einem erhöhten Verletzungsrisiko. Welcher Parameter des glenohumeralen Bewegungsausmass von höchster Relevanz ist, bleibt jedoch unklar. Schlussfolgerung: Die untersuchten Variablen konnten studienübergreifend nicht als eindeutige Risikofaktoren identifiziert werden. Mit Blick auf die Resultate sollte der Schwerpunkt zukünftiger Präventions- und Rehabilitationsprogramme in der Kräftigung der Aussenrotatoren der Schultermuskulatur liegen., Background: Handball is considered one of the team sports most prone to injuries, with the shoulder being the fourth most commonly affected joint. The majority of these injuries are due to chronic overuse. The evaluation of possible risk factors is key to the development of effective injury prevention and rehabilitation programs. Aim: To investigate whether scapular dyskinesis, glenohumeral range of motion deficits, or an imbalance of the shoulder rotator muscles are considered risk factors for the development of overuse shoulder injuries. Methods: A literature research was performed in PubMed, SportDiscus, and CINAHL. The four included studies were critically appraised using the Working tool for critical appraisal of the Zurich University of Applied Sciences. Results: Three out of four studies significantly associated reduced external rotator strength and at least one aspect of glenohumeral range of motion with overuse shoulder injuries. However, it remains unclear which movement parameter is most important. Conclusion: Based on the presented results none of the study variables have consistently been identified as risk factors. Nevertheless, the results promote strengthening of the external shoulder rotators in future prevention and rehabilitation programs.

Hintergrund: Handball wird als eine der verletzungsanfälligsten Mannschaftssportarten überhaupt bezeichnet und die Schulter stellt dabei das vierthäufigste betroffene Gelenk dar. Die Mehrheit dieser Verletzungen sind auf chronische Überbelastungen zurückzuführen. Zur Entwicklung von Präventions- und Rehabilitationsprogrammen ist es essenziell, die Risikofaktoren solcher Verletzungen zu kennen. Ziel: Den Zusammenhang zwischen Skapuladyskinesie, signifikanten Unterschieden des glenohumeralen Bewegungsausmasses im Seitenvergleich, sowie einem muskulären Missverhältnis der Aussenrotatorenkraft zur Innenrotatorenkraft und dem Risiko für nichttraumatische Schulterverletzungen zu eruieren. Methodik: Anhand einer systematischen Literaturrecherche in den Datenbanken PubMed, SportDiscus und CINAHL wurden vier relevante Studien identifiziert und anhand des Arbeitsinstruments Critical Appraisal der Zürcher Hochschule für Angewandte Wissenschaften kritisch gewürdigt. Ergebnisse: Drei der vier Studien erhoben einen signifikanten Zusammenhang zwischen einer reduzierten Aussenrotationskraft sowie Veränderungen des glenohumeralen Bewegungsausmasses im Seitenvergleich und einem erhöhten Verletzungsrisiko. Welcher Parameter des glenohumeralen Bewegungsausmass von höchster Relevanz ist, bleibt jedoch unklar. Schlussfolgerung: Die untersuchten Variablen konnten studienübergreifend nicht als eindeutige Risikofaktoren identifiziert werden. Mit Blick auf die Resultate sollte der Schwerpunkt zukünftiger Präventions- und Rehabilitationsprogramme in der Kräftigung der Aussenrotatoren der Schultermuskulatur liegen., Background: Handball is considered one of the team sports most prone to injuries, with the shoulder being the fourth most commonly affected joint. The majority of these injuries are due to chronic overuse. The evaluation of possible risk factors is key to the development of effective injury prevention and rehabilitation programs. Aim: To investigate whether scapular dyskinesis, glenohumeral range of motion deficits, or an imbalance of the shoulder rotator muscles are considered risk factors for the development of overuse shoulder injuries. Methods: A literature research was performed in PubMed, SportDiscus, and CINAHL. The four included studies were critically appraised using the Working tool for critical appraisal of the Zurich University of Applied Sciences. Results: Three out of four studies significantly associated reduced external rotator strength and at least one aspect of glenohumeral range of motion with overuse shoulder injuries. However, it remains unclear which movement parameter is most important. Conclusion: Based on the presented results none of the study variables have consistently been identified as risk factors. Nevertheless, the results promote strengthening of the external shoulder rotators in future prevention and rehabilitation programs.

Hintergrund: Handball wird als eine der verletzungsanfälligsten Mannschaftssportarten überhaupt bezeichnet und die Schulter stellt dabei das vierthäufigste betroffene Gelenk dar. Die Mehrheit dieser Verletzungen sind auf chronische Überbelastungen zurückzuführen. Zur Entwicklung von Präventions- und Rehabilitationsprogrammen ist es essenziell, die Risikofaktoren solcher Verletzungen zu kennen. Ziel: Den Zusammenhang zwischen Skapuladyskinesie, signifikanten Unterschieden des glenohumeralen Bewegungsausmasses im Seitenvergleich, sowie einem muskulären Missverhältnis der Aussenrotatorenkraft zur Innenrotatorenkraft und dem Risiko für nichttraumatische Schulterverletzungen zu eruieren. Methodik: Anhand einer systematischen Literaturrecherche in den Datenbanken PubMed, SportDiscus und CINAHL wurden vier relevante Studien identifiziert und anhand des Arbeitsinstruments Critical Appraisal der Zürcher Hochschule für Angewandte Wissenschaften kritisch gewürdigt. Ergebnisse: Drei der vier Studien erhoben einen signifikanten Zusammenhang zwischen einer reduzierten Aussenrotationskraft sowie Veränderungen des glenohumeralen Bewegungsausmasses im Seitenvergleich und einem erhöhten Verletzungsrisiko. Welcher Parameter des glenohumeralen Bewegungsausmass von höchster Relevanz ist, bleibt jedoch unklar. Schlussfolgerung: Die untersuchten Variablen konnten studienübergreifend nicht als eindeutige Risikofaktoren identifiziert werden. Mit Blick auf die Resultate sollte der Schwerpunkt zukünftiger Präventions- und Rehabilitationsprogramme in der Kräftigung der Aussenrotatoren der Schultermuskulatur liegen., Background: Handball is considered one of the team sports most prone to injuries, with the shoulder being the fourth most commonly affected joint. The majority of these injuries are due to chronic overuse. The evaluation of possible risk factors is key to the development of effective injury prevention and rehabilitation programs. Aim: To investigate whether scapular dyskinesis, glenohumeral range of motion deficits, or an imbalance of the shoulder rotator muscles are considered risk factors for the development of overuse shoulder injuries. Methods: A literature research was performed in PubMed, SportDiscus, and CINAHL. The four included studies were critically appraised using the Working tool for critical appraisal of the Zurich University of Applied Sciences. Results: Three out of four studies significantly associated reduced external rotator strength and at least one aspect of glenohumeral range of motion with overuse shoulder injuries. However, it remains unclear which movement parameter is most important. Conclusion: Based on the presented results none of the study variables have consistently been identified as risk factors. Nevertheless, the results promote strengthening of the external shoulder rotators in future prevention and rehabilitation programs.

[Resumen] Objetivo. El objetivo de este trabajo es determinar la eficacia del tratamiento de la discinesis escapular a través de la intervención fisioterapéutica, para disminuir el dolor de hombro y la disfunción en nadadores con impingement subacromial, también conocida como la patología del “hombro de nadador”. Material y método. Este trabajo es una revisión bibliográfica de tipo sistemática, en la que se realiza una búsqueda en las diferentes bases de datos disponibles en materia de ciencias de la salud, como son Cochrane, Pubmed, ScienceDirect, Scopus y PEDro, entre otras. En cuanto a los criterios de selección, incluimos estudios de meta-análisis, revisiones, revisiones sistemáticas, ensayos clínicos, ensayos clínicos controlados, ensayos clínicos aleatorizados y guías de práctica clínica; cuyos participantes sean pacientes con dolor de hombro, impingement subacromial y presenten discinesis escapular, y sean tratados mediante fisioterapia. Se seleccionan textos disponibles en español, inglés y portugués. Se excluyen los artículos que estén duplicados, que no se ajusten a los objetivos del estudio y aquellos cuya fecha de publicación sea anterior a 2015. En relación con las variables de estudio, se tienen en cuenta individuos independientemente de su sexo, tanto hombres como mujeres, cuya edad esté comprendida entre la adolescencia y adultez (ambas inclusive). Resultados. Finalmente se analizan un total de 10 textos, entre los cuales suman una variedad de intervenciones de fisioterapia que se acostumbran a llevar a cabo, y se analizan la evidencia y resultados de cada una de ellas. Conclusiones. Un programa de ejercicio terapéutico basado en el tratamiento de la discinesis escapular, es, en la mayoría de los casos, eficaz para reducir la disfunción y el dolor de hombro en pacientes con SIS. Por lo tanto, aquellos nadadores con clínica de impingement subacromial o “patología del hombro de nadador”, y que presenten alteraciones escapulares; que se sometan a este t, [Abstract] Aim. The aim in this review is to identify the effectiveness of treating scapular dyskinesis by physiotherapy intervention, to reduce shoulder pain and disability in swimmers with Subacromial Impingement Syndrome (SIS), also known as “Swimmer Shoulder”. Methods. This Project is a systematic review, for which it was carried out a research on diverse available databases of health sciences, such as Cochrane Library, Pubmed, ScienceDirect, Scopus and PEDro. Dealing with selection criteria, the included articles were studies of meta-analysis, reviews, systematic reviews, clinical trials, controlled clinical trials, randomized clinical trials and clinical practice guidelines, which pacients had shoulder pain, SIS and scapular dyskinesis, treated by physiotherapy intervention. Texts available in Spanish, English or Portuguese were included. On the other hand, duplicated articles, those which does not fit the aim of this study and those which were published before 2015 were excluded. Respect to study variables, individuals, regardless their sex, and whose age is between adolescence and adulhood are considered Results. Finally, 10 different texts were analyzed, resulting in a diferent variety of physical therapy interventions that professional physiotherapists usually carry out. Evidency and results of all of them were also analyzed. Conclusions. A therapeutic exercise program based on treating the scapular dyskinesis, is, in the major of cases, effective to reduce disability and shoulder pain in patients with SIS. In fact, those swimmers who have subacromial impingement symptoms or “swimmer’s shoulder disease”, also presenting scapular disfunctions, and treated through this physiotherapy intervention, will obtain positive results dealing with reducing shoulder pain. However, more literature is still needed, and we must keep investigating to reach the most effective protocol intervention or program to treat SIS and scapular dyskinesis., [Resumo] Obxectivo. O obxectivo deste traballo é determinar a eficacia do tratamento da discinese escapular mediante a intervención fisioterapéutica, para reducir a dor de ombreiro e a disfunción en nadadores con impingement subacromial, tamén coñecida como a patoloxía do “ombreiro de nadador”. Material y método. Este traballo é unha revisión bibliográfica de tipo sistemática, na que se realiza una búsqueda nas diferentes bases de datos dispoñibles en materia de ciencias da saúde, como son Cochrane, Pubmed, ScienceDirect, Scopus e PEDro, entre outras. En canto aos criterios de selección, incluimos estudos de meta-análisis, revisións, revisións sistemáticas, ensaios clínicos, ensaios clínicos controlados, ensaios clínicos aleatorizados e guías de práctica clínica; nos que os participantes sexan pacientes con dolor de ombreiro, impingement subacromial, presenten discinese escapular, e sexan tratados mediante fisioterapia. Selecciónanse textos dispoñibles en español, inglés e portugués. Exclúense aqueles artigos que estén duplicados, os que non se axusten ós objetivos do estudo e aqueles cuxa data de publicación sexa anterior ó 2015. En relación cas variables de estudo, téñense en conta individuos independientemente do seu sexo, tanto homes coma mulleres, con idades comprendidas entre a adolescencia e a adultez. Resultados. Finalmente, analízanse un total de 10 textos, entre os cales suman unha variedade de intervencións de fisioterapia, que normalmente se levan a cabo; analizando a evidencia e os resultados de cada unha delas. Conclusións. Un programa de exercicio terapéutico basado no tratamento da discinese escapular, é, na maioría dos casos, eficaz para reducir a disfunción e a dor de ombreiro en pacientes con SIS. Polo tanto, aqueles nadadores con clínica de impingement subacromial ou “patoloxía do ombreiro de nadador”, e que presenten alteracións escapulares; que se somentan a este tratamento de fisioterapia, obterán resultados positivos en canto á reducción da d

The pitching motion is an asymmetric action by which coordination of scapular rotation in the dominant arm might be affected in time and in comparison with the non-dominant arm. The study aimed to compare asymmetry and the evolution of scapular upward rotation over a one-year period. Data were collected twice, before and after a one-year period, from 92 participants (age = 15.1 SD 1.4 years, body height = 177.3 SD 10.9 cm, body weight 69.2 SD 14.5 kg). Scapular motion was tracked at different glenohumeral angles of elevation in the scapular plane: anatomical position (0°), 45°, 90° and 135°. Scapular upward rotation was calculated as the angle between the spinae scapula and the spine. Scapular upward rotation of the dominant arm was 5.1° (95% CI: 2.1°−8.1°) more compared to the non-dominant arm. Age group or glenohumeral angles of elevation did not affect this difference. Scapular upward rotation of the dominant arm decreased 1.9° (95% CI: −0.5° to 4.3°) after a one-year period, however, neither this observation, nor the interaction with age group or elevation angle was significant. These findings may indicate that pitchers could be at risk to develop shoulder injuries especially those that have been associated with scapular asymmetry., Biomechanical Engineering, Biomechatronics & Human-Machine Control

The pitching motion is an asymmetric action by which coordination of scapular rotation in the dominant arm might be affected in time and in comparison with the non-dominant arm. The study aimed to compare asymmetry and the evolution of scapular upward rotation over a one-year period. Data were collected twice, before and after a one-year period, from 92 participants (age = 15.1 SD 1.4 years, body height = 177.3 SD 10.9 cm, body weight 69.2 SD 14.5 kg). Scapular motion was tracked at different glenohumeral angles of elevation in the scapular plane: anatomical position (0°), 45°, 90° and 135°. Scapular upward rotation was calculated as the angle between the spinae scapula and the spine. Scapular upward rotation of the dominant arm was 5.1° (95% CI: 2.1°−8.1°) more compared to the non-dominant arm. Age group or glenohumeral angles of elevation did not affect this difference. Scapular upward rotation of the dominant arm decreased 1.9° (95% CI: −0.5° to 4.3°) after a one-year period, however, neither this observation, nor the interaction with age group or elevation angle was significant. These findings may indicate that pitchers could be at risk to develop shoulder injuries especially those that have been associated with scapular asymmetry., Biomechanical Engineering, Biomechatronics & Human-Machine Control

The optimal treatment of grade III acromioclavicular (AC) dislocation is still controversial. Recent studies recommend surgery at that stage whereas meta-analysis favours conservative management. The objective of the present investigation was to analyse a clinical series of non-operated grade III AC dislocations and to determine their functional status. Thirty-five patients treated conservatively with a grade III acromioclavicular dislocation were retrospectively reviewed. Simple shoulder test, Oxford shoulder and bilateral Constant shoulder score were used for assessment. Various predictive criteria of poor outcome, particularly scapular dyskinesis were taken into account for analysis. Overall mean and median Constant Score of the injured side were 92.9 and 94, whilst the contralateral shoulder values were respectively 94.9 and 95 (mean and median scores). Ten patients had scapular dyskinesis. Laterality, shoulder activity and scapular dyskinesis were not statistically related to worse outcome. Twenty-eight (80%) patients resumed normal activity within six months. All but two patients were subjectively very satisfied or satisfied. Conservative treatment provided satisfactory results whatever the shoulder activity. No risk factors were predictive of a poorer outcome. Conservative management should remain the first option to manage these injuries.