title: Overload and neovascularization of shoulder tendons in volleyball players.
abstract: BACKGROUND
  In overhead sports like volleyball, the onset of a rotator cuff tendinopathy due to functional overload is a common observation. An angiofibroblastic etiopathogenesis has been hypothesized, whereby a greater anaerobic metabolism occurs in critical zones of the tendon with a lower degree of vascularization; this would induce collagen and extracellular matrix degradation, that could then trigger a compensatory neovascularization response. We performed a clinical observational study of 80 elite volleyball players, monitoring the perfusion values of the supraspinatus tendons by oximetry.
  
  
  RESULTS
  No statistically significant differences were found between the oximetry data and age, sex or years of sports activity, nor when comparing the right and left arm or the dominant and non-dominant arm. A statistically significant difference was found for the dominant arm values in relation to the competitive role, higher values being obtained in outside hitters (62.7%) than middle hitters (53.7%) (p = 0.01), opposite hitters (55.5%) (p = 0.02) and libero players (54.4%) (p = 0.008), whereas there were no differences in setters (56.2%) (p > 0.05).
  
  
  CONCLUSIONS
  The different tendon vascularization values found in players with different roles in the team may be attributed to a response to the specific biomechanical demands posed by the different overhead throwing roles.
authors.affiliation: Course of Motor and Sports Sciences, Faculty of Medicine and Surgery, University of Study of Bari, Lungomare Starita 1, 70123, Bari, Italy. angelanotarnicola@yahoo.it
authors.forename: Angela
authors.initials: A
authors.lastname: Notarnicola
authors.forename: Francesco
authors.initials: F
authors.lastname: Fischetti
authors.forename: Donato
authors.initials: D
authors.lastname: Gallone
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Moretti
authors.forename: Pasquale
authors.initials: P
authors.lastname: Pignataro
authors.forename: Silvio
authors.initials: S
authors.lastname: Tafuri
authors.forename: Biagio
authors.initials: B
authors.lastname: Moretti
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D009389:Neovascularization, Pathologic; D017006:Rotator Cuff / Q000098:blood supply*; D013710:Tendons / Q000098:blood supply*; D014463:Ultrasonography; D054798:Volleyball; D055815:Young Adult