A PIONEERING RESEARCH ON SHOULDER MUSCLE ACTIVATION IN HANDBALL PLAYERS
Handball is one of the sports that are encompassed by the term overhead, a concept that includes sports based on a movement in which the arm is brought above the head.
Muscle injuries are one of the most frequent causes of injury in sport. According to some studies, an elite-level soccer team can expect to suffer 15 instances of muscle injury every season, which is equal to more than 200 lost days of training for the entire team. Despite the significance of muscle injuries, there is still no objective and globally accepted classification that would support improved understanding and prognosis.
Recently, part of the FC Barcelona medical team, together with the Duke Sports Science Institute in the United States and the Aspetar Hospital in Qatar, have published an article in the journal Sports Medicine that establishes a new four point classification system. This model, which is already being used at the club, will facilitate communication between professionals and will support the treatment and rehabilitation process.
“For a long time, muscle injuries were classified based on a clinical evaluation (that is, through what the athlete reported feeling and a physical examination), says Xavier Valle, FC Barcelona physician and the first author listed for the article. “Later, classifications based on imaging tests started to appear – such as ultrasound and magnetic resonance – which are more objective. However, protocols for taking action are not the same across all clubs, which makes conducting research more difficult. This is perhaps the reason why we still don’t have a widely-accepted classification system”, he continues.
In the last few years some different models have emerged, such as the Munich consensus statement or the British system. Both models use ambiguous terms, which makes it difficult to assess their true value or universality.
To establish the new classification, a protocol was established by which the available scientific evidence was thoroughly reviewed (especially for the hamstring and rectus femoris muscles) and several meetings were held whereby doctors from the three centers shared information and worked on reaching a consensus and agreement.
Finally, a four-point classification system was established, based on four letters: MLG-R, which refers to (M)echanism of the injury, (L)ocation of the injury, (G)rading of severity and number of muscle (R)e-injuries.
Broadly speaking, the criteria can be defined as follows:
“In general, the goal of the four points is to quantify the quantity of affected connective tissue,” explains Valle. (Connective tissue is a kind of matrix in which muscle cells are arranged and is fundamental for transmitting strength and muscle function). Nevertheless, despite the fact that these criteria are already being used, their reliability must still be evaluated. “It’s the next step;” confirms the specialist. “We now have a sample of more than 100 cases which will allow us to test the model.”
In any case, the model is flexible and it is important that it remains a “living” concept, open to new emerging knowledge. “We are going to keep working on testing the model and building more solid conclusions,” affirms Valle. Currently, classification is based almost exclusively on data from imaging tests, not clinical evaluations. “We are also evaluating whether criteria such as the percentage of loss of strength due to the injury or the time elapsed before walking without pain could be incorporated, but at the moment there is no clear evidence for these two indicators.”
Nowadays, imaging tests are not sufficient (not considered useful) in terms of the decision about when to return to competition, but Valle is clear that an objective and appropriate classification would improve the accuracy of prognosis, allow treatment to be adjusted and reduce the risk of re-injury.”
That would be no small achievement.
The Barça Innovation Hub team
Mental abilities, although not yet fully appreciated, are already considered a relevant part of performance. But their importance could go beyond that: Do they also influence the injury risk, including recurrence, once the player returns to play?
Although several studies have tried to evaluate the characteristics of the risk of injury in handball players, they have been unable to reach sufficiently reliable conclusions. A new study of all the FC Barcelona handball categories has attempted to shed more light on the subject.
Although there are several studies on this topic, many of them have analyzed these demands by looking at just a few variables or using very broad timeframes. A new study completed by physical trainers from F.C. Barcelona has analyzed several of these details more closely.
An article published in The Orthopaedic Journal of Sports Medicine —in which members of the club’s medical services participated— now suggests to consider the detailed structure of the area affected, and treating the extracellular matrix as an essential player in the prognosis of the injury.
For the first time, it has been demonstrated that it does not take months of training to significantly improve both muscle volume and strength; instead, two weeks of an appropriate exercise are enough.
Training using eccentric exercises is important to prevent possible damage. However, intensive training can also cause muscle damage, so it is critical to be vigilant in order to keep injury risk to an absolute minimum.
Cardiovascular endurance manifests as a moderator of the load result to which the athlete is exposed.
Through the use of computer vision we can identify some shortcomings in the body orientation of players in different game situations.