title: Range of motion and isometric strength of shoulder joints of team handball athletes during the playing season, Part II: changes after midseason.
abstract: OBJECTIVE
  Our objective was to investigate the influence of workload and consecutive changes on active range of motion and isometric strength of team handball athletes' throwing shoulders (TSs) because the available data are insufficient.
  
  
  METHODS
  In a longitudinal investigation, 31 professional male handball athletes underwent a clinical shoulder examination. Athletes were examined at the beginning (week 0), at the end (week 6) of the preseasonal training, and at the end of the half-season (week 22) on both shoulders to determine isometric rotational strength (hand held dynamometer) and active range of motion (goniometer).
  
  
  RESULTS
  This analysis demonstrates the results subsequently from week 6 to week 22 and from week 0 to week 22. The glenohumeral internal rotation (IR) deficit (GIRD), external rotation (ER) gain, and ER at the TS increased significantly (P < .05, η(2) > 0.10, d > 0.30) in the first sequence (week 6 to week 22) but not significantly from week 0 to week 22. The total range of motion remained stable, and IR changed but not significantly. There was no influence on IR, ER, and total range of motion at the non-TS. The isometric strength of the TS and non-TS IR did not change. The isometric strength in ER significantly increased bilaterally during the investigation period.
  
  
  CONCLUSIONS
  Our data verify changes and influences, such as an increasing GIRD, at the overhead TS joint in accordance with the workload during team handball season. ER gain did improve after the half-season period but did not fully compensate the GIRD at the TS.
authors.affiliation: Center for Orthopedic Surgery, Hann. Münden, Germany. Electronic address: dr.fieseler@zoc-hann-muenden.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Fieseler
authors.affiliation: Center for Orthopedic Surgery, Hann. Münden, Germany; Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Jungermann
authors.affiliation: Center for Orthopedic Surgery, Hann. Münden, Germany; Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Koke
authors.affiliation: Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Irlenbusch
authors.affiliation: Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Karl-Stefan
authors.initials: KS
authors.lastname: Delank
authors.affiliation: Department for Trauma & Orthopedic Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
authors.forename: Rene
authors.initials: R
authors.lastname: Schwesig
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D009038:Motion; D053580:Muscle Strength; D016059:Range of Motion, Articular; D012399:Rotation; D012785:Shoulder Joint / Q000502:physiology / Q000503:physiopathology*
keywords: Overhead sports injury; external rotation gain (ERG); glenohumeral internal rotation deficit (GIRD); rotation capacity; thrower's shoulder