Increased posterior shoulder capsule thickness in youth elite handball players: a sonographic investigation

• Published in: Journal of shoulder and elbow surgery 2021-01, Vol.30 (1), p.194-199
• Main Authors: Winkelmann, Moritz T., Walter, Sven S., Laver, Lior, Zeman, Florian, Fehske, Kai, Achenbach, Leonard
• Format: Article
• Language: English
• Subjects: adaption; injury; overuse; shoulder; Throwing; ultrasound
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2020.04.047

Range of motion adaptations in the shoulders of overhead throwing athletes have been reported, but knowledge about the development of soft-tissue adaptations is limited. The purpose of this study was to investigate differences in posterior shoulder capsule thickness and internal rotation between the throwing and non-throwing shoulder. On the basis of the sample size calculation, we assessed 63 youth elite handball players (33 boys and 30 girls, mean age: 13.6 ± 0.9 years) for glenohumeral internal and external rotational range of motion, humeral retrotorsion, and posterior capsule thickness (PCT) with a manual goniometer and a portable ultrasound device and calculated sports-specific differences between the throwing and non-throwing shoulder as well as correlations with PCT. Youth handball players showed side-to-side differences in internal rotation, external rotation, and humeral retrotorsion between the throwing and non-throwing shoulder. Posterior shoulder capsules were 1.21 times thicker (95% confidence interval: 1.1-1.3) in the throwing shoulder than in the non-throwing shoulder (1.3 ± 0.3 mm vs. 1.2 ± 0.2 mm, P < .0001). Loss of internal rotation did not correlate with PCT. In youth elite handball athletes, posterior shoulder tightness and subsequent sports-specific loss of internal rotation in the throwing shoulder are not related to PCT. Thus, in this age class, other (soft-tissue) factors must be responsible for this condition.