Tell us more about yourself and the author team
At the time of publication, I am working as a shoulder and elbow surgeon at the König-Ludwig-Haus, which is part of the University of Würzburg, and as a sports medicine physician with a professional football team. I have the background of a former handball player and handball youth coach. Our research team comprises orthopaedic and trauma surgeons, a statistician, a clinical data manager and a national handball coach. Our research focus is on primary and secondary injury prevention in amateur and professional team sports.
What is the story behind your study?
Together with the Bavarian Handball Federation, part of the German Handball Federation, we continuously work on developing injury prevention exercises for the ‘prevention-ABC’, an online exercise manual for handball coaches and handball players. The ‘prevention-ABC’ was first established after a pilot randomized controlled trial about the effectiveness of equipment-free exercises for the prevention of severe knee injury in youth handball in 2015. Since 2019, the manual is integrated in the coaches’ training curriculum in Bavaria. In the last years, we have collaborated with further handball federations in Germany to improve our understanding of overuse injury of the throwing shoulder in handball and to identify modifiable risk factors. In this study, we aimed to determine the effectiveness of the exercises currently in use for the prevention of overuse shoulder injury in handball in Bavaria.
In your own words, what did you find?
The ‘romantic’ idea to prepare your throwing shoulder to withstand the demands of handball with rubber bands and stretching seems not enough.
What was the main challenge you faced in your study?
Our main challenge was to counteract the questionnaire fatigue due to the repetitive biweekly questionnaires for a whole season. We had to make a considerable effort to engage the coaches and players and motivate them to respond. At the end of the season, we had to prematurely end the study due to the consequences of the outbreak of the covid-19 pandemic in Germany. A further challenge was to work and interpret the data from over 825 participating athletes. I want to thank the clinical data manager and statistician for their tremendous help working with this large dataset.
If there is one take-home message from your study, what would that be?
Exercises with a low training stimulus, such as rubber bands, seem inefficient to prevent overuse injury of the throwing shoulder. Exercises with a higher training stimulus should be more encouraged for handball athletes.