This research report is presented to the University of the Witwatersrand in partial fulfilment of the requirements for the degree of Master of Science in Physiotherapy Johannesburg, 2017 / BACKGROUND: The game of cricket requires the repetitive use of the upper limbs in batting, bowling and fielding. Shoulder injuries are prevalent in cricket players with the most common activities causing injury being fielding and bowling. There is no research on pectoralis minor muscle length in cricketers or the role that the throwing arc range of movement (ROM) plays in shoulder injuries, in a male only cricket population older than 18 years of age. OBJECTIVE: The objective of this study was to determine if there is an association between shoulder rotation ROM, throwing arc ROM, pectoralis minor muscle length, and incidence of shoulder injury, as monitored in the first three months of a cricket season METHOD: This was a prospective, observational cohort study. Thirty six male, provincial and club cricket players, with and without shoulder pain, were recruited. Shoulder internal rotation ROM, external rotation ROM and pectoralis minor muscle length test distance were measured at the beginning of a cricket season and during the first three weeks of the in-season. Glenohumeral internal rotation deficit (GIRD), external rotation gain (ERG) and throwing arc ROM were calculated from these measurements. The incidence of injury was monitored for three months. Comparisons were made between the injured and uninjured groups. Parametric data were analysed using independent t-tests and paired t-tests. Non-parametric data were analysed with the Mann-Whitney U tests, chi-squared tests and Sign tests. A logistic regression model was used to determine the relationship between variables. RESULTS: Thirty six participants were recruited and underwent the baseline testing procedure, although only thirty two participants’ data were analysed. During the study, four participants were not exposed to the typical cricket training and match workloads and were therefore excluded from the study. The mean age of participants was 23.56 (SD ± 4.27) years. Nine participants (28%) sustained dominant shoulder injuries and twenty-three (72%) remained uninjured. The presence of initial shoulder pain at rest, during or after training (p = 0.007) at the beginning of the season occurred in six participants who sustained shoulder injuries during the season. There were no statistically significant differences between the injured and uninjured group in any of the other variables. All pre-season measurements in the entire group were significantly different between the dominant and non-dominant upper limb. The external rotation ROM (p = 0.0037) was increased on the dominant side and the internal rotation ROM (p < 0.0001), throwing arc ROM (p = 0.016) and pectoralis minor muscle length (p = 0.0001) (decreased pectoralis minor length test distance) was increased on the non-dominant side. In the injured group, there was no significant difference between dominant and non-dominant measurements. The uninjured group had a smaller dominant internal rotation ROM (p = 0.0001), throwing arc ROM (p = 0.005) and pectoralis minor muscle length (p = 0.0002) (larger pectoralis minor length test distance) which was statistically significantly different to the non-dominant shoulder. A logistic regression analysis found no association between the variables and injury. CONCLUSION: Shoulder pain at the beginning of the season may be a precursor to shoulder injuries in cricket players. The presence of pain should be questioned during the pre-season screening, so that preventative programmes may be put into place to prevent shoulder injuries which result in time out of play. Asymmetries were found in the uninjured group with internal rotation ROM, throwing arc ROM and pectoralis minor muscle length although, no asymmetries existed in the injured group. These asymmetries may have a protective role in injury prevention whereas, non-asymmetries (as seen in the injured participants) may precipitate dominant shoulder injuries. / MT2017

By understanding the normal humeral and scapular kinematics during the kayak stroke, inferences about the relationship of kayaking technique and shoulder injury may be established. The purpose of this study was to describe scapular and humeral kinematics and to compare dominant versus non-dominant symmetry in healthy whitewater kayakers performing the forward stroke. Twenty-five competent whitewater kayakers (mean age: 34.1±9.4 years, mean height: 1.768±0.093 m, mean mass: 78.2±13.0 kg) underwent humeral and scapular kinematic assessment, using an electromagnetic tracking device, while kayaking on a kayak ergometer. Paired t-tests were used to determine symmetry. Scapular and humeral kinematic means and standard deviations at six time points during the kayak stroke were described. Scapular and humeral kinematics were shown to be similar upon bilateral comparison. The greatest potential for injury during the forward stroke may be at thrust paddle shaft vertical when the humerus is maximally elevated in internal rotation and adduction as subacromial structures may be mechanically impinged. The relationship between scapulohumeral kinematics related to injury at other time points are also described.

As the work force ages and workers retirement age increases, the number of workers suffering from Work-related Musculoskeletal Disorders (WMSDs) has increased. In a recent study, the U.S Bureau of Labor reported that 6.9% of all WMSDs affected shoulders. Electricians, carpenters, and related construction crafts appear to experience higher incidence of these injuries due the nature of their work that require them often to use Awkward shoulder postures. This research aims to develop a new monitoring system that measure the amount of time workers spend in awkward shoulder postures to help decrease the prevalence of cumulative shoulder injuries and to reduce the number of cases of shoulder WMSDs among construction workers. The monitoring system was designed and a feasibility study was conduct to compare the monitoring system with a state of the art motion tracking system. Overall the monitoring system was able to count the time spent in awkward posture as a discrete state sensor and it can be implemented in the field. However, results showed that the monitoring system in its current configuration require some future work for it to produce quantitatively precise results that can be used in the fields of biomechanics, robotics, and ergonomics.

Bakgrund: Axelskador är vanligt förekommande inom idrott. Det finns ett tydligt samband mellan axelskador och idrotter som innefattar hand- och armrörelser ovanför huvudhöjd, som till exempel handboll. Axellederna utsätts för såväl hård fysisk kontakt som hög belastning vid repetitiva kaströrelser vilket ställer stora krav på axelledens strukturer. Prevalensen av aktuell eller tidigare axelskada rapporteras vara mellan 58 till 75 % hos spelarna. Syfte: Syftet med studien var att undersöka hur ett preventivt träningsprogram riktat mot riskfaktorer för skada i axelleden, utfört under åtta veckor i slutskedet av tävlingssäsong, påverkade prevalensen av överbelastningsskador i axelleden hos elithandbollsspelare i Sverige. Hur påverkas prevalensen av överbelastningskador och av allvarliga överbelastningsskador i axelleden under åtta veckor med samtidigt genomförande av ett preventivt träningsprogram för axelleden på elithandbollsspelare i Sverige? Metod: Studien var av kvasi-experimentell design vilken bestod av sex mättillfällen under åtta veckor. Nio elithandbollslag aktiva i Mellansverige rekryterades, varav 110 av 162 tillgängliga spelare inkluderades vid studiestart. Exkludering under och efter studieperioden gjorde att analysen utfördes på ett färre antal spelare. Lagen delades in i interventions- (n = 48) eller kontrollgrupp (n = 32) genom stratifierat urval, medelålder (± SD) 22.0 (3.3) respektive 21.9 (4.0). Interventionsgruppen tilldelades ett preventivt träningsprogram bestående av tre övningar i syfte att förbättra riskfaktorer för axelskador hos ”overhead athletes”. Kontrollgruppen tilldelades ingen intervention. Träningsprogrammet utvärderades genom att analysera prevalensen av överbelastningsskada och allvarlig överbelastningsskada i axelleden mätt med en modifierad version av The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire. Resultat: Totalt 455 överbelastningssymtom rapporterades hos 42 spelare (53 %) varav 95 symtom var allvarliga hos 18 spelare (23 %). Prevalensen av överbelastningsskada minskade för både interventions- och kontrollgruppen från 42 % (95 % CI 28-56 %) till 25 % (95 % CI 13-37 %) respektive 53 % (95 % CI 36-70 %) till 31 % (95 % CI 15-47 %). Prevalensen av allvarliga överbelastningsskador minskade för både interventions- och kontrollgruppen från 15 % (95 % CI 5-25 %) till 6 % (95 % CI -1-13 %) respektive 19 % (95 % CI 5-32 %) till 13 % (95 % CI 1-24 %). Det fanns ingen signifikant skillnad mellan grupperna gällande prevalensen efter åtta veckors intervention. Allvarlighetspoängen minskade genomgående med en signifikant skillnad (p = 0.001) över tid för båda grupperna där kontrollgruppen förbättrades något mer. Det fanns en tendens till skillnad mellan grupperna (p = 0.064) gällande allvarlighetspoäng. Slutsats: Resultaten av denna studie visar på att prevalensen av allvarlig överbelastningsskada i axelleden hos elithandbollsspelare i Sverige möjligtvis kan reduceras till viss del genom utförande av ett preventivt träningsprogram två eller fler gånger per vecka under åtta veckor. Prevalensen av allvarliga symtom för överbelastningsskada minskade till ett något lägre värde för interventionsgruppen. Skillnaden för prevalens av överbelastningsskada inom interventionsgruppen, undergrupperade på antal utförda förebyggande träningspass, var signifikant (p = 0.044). Allvarlighetspoängen minskade i båda grupperna under studien. Det fanns en tendens till signifikant skillnad mellan grupperna (p = 0,.064), där kontrollgruppen förbättrades något mer trots ett högre värde vid mätning vecka 8. Axelskada och dysfunktioner hos ”overhead athletes” kan orsakas av olika faktorer vilket innebär att även riskfaktorerna bakom var och en av dessa tillstånd kan variera. Det är därför viktigt att upplysa om att träningsprogrammets påverkan på individnivå kan se annorlunda ut jämfört med resultatet på gruppnivå i den större populationen. / Background: Shoulder injuries are common in sport. In particular there is a clear relationship between shoulder injuries and sports that includes hand- and arm movements over the head, for example handball. In handball, the shoulder joints are exposed to hard physical contact as well as high loads during repetitive throwing which puts high demands on the structures inside and surrounding the shoulder joint. The prevalence of current or previous shoulder injuries is reported to be between 58 to 75 % in studies of handball players. Aim: The purpose of this study was to investigate how a preventive training program aimed at risk factors for shoulder injuries in the shoulder joint, performed during eight weeks in the final stage of competitive season, affected the prevalence of overuse injuries in the shoulder joint for elite handball players in Sweden.  How is the prevalence of overuse injuries and severe overuse injuries in the shoulder joints of elite Swedish handball players affected by the implementation of an eight-week preventive training program? Method: The study was of a quasi-experimental design which consisted of six measurements taken during eight weeks. Nine elite handball teams active in the middle regions of Sweden were recruited, from which 110 of the 162 available players were included. Exclusions during and after the study period reduced the number of players. The teams were divided into an intervention (n = 48) or control group (n = 32) through stratified sampling, with mean age (± SD) 22.0 (3.3) and 21.9 (4.0), respectively. The intervention group was assigned a preventive exercise program consisting of three exercises with the purpose of improving riskfactors for shoulder injuries for overhead athletes. The control group was not assigned any intervention. The training program was evaluated by analyzing the prevalence of overuse and severe overuse symptoms in the shoulder measured with a modified version of The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire. Results: A total of 455 overuse symptoms were reported by 42 players (53 %) of which 95 symptoms in 18 players (23 %) were severe. The prevalence of overuse injuries decreased in both the intervention and the control group from 42 % (95 % CI 28-56 %) to 25 % (95 % CI 13-37 %) and 53 % (95 % CI 36-70 %) to 31 % (95 % CI 15-47 %), respectively. The prevalence of severe overuse injuries decreased in both the intervention and the control group from 15 % (95 % CI 5-25 %) to 6 % (95 % CI -1-13 %) and 19 % (95 % CI 5-32 %) to 13 % (95 % CI 1-24 %), respectively. There was no significant difference between the groups regarding prevalence after the intervention of eight weeks. Severity score consistently decreased with a significant difference over time (p = 0.001) for both groups, with a slightly greater improvement in the control group. There was a tendency towarda difference between the groups (p = 0.064) regarding the severity score. Conclusions: The results of this study show that the prevalence of severe overuse injuries in the shoulder joint of elite handball players in Sweden might be reduced to some extent by performing a preventive exercise program two or more times per week for eight weeks. The prevalence of severe symptoms of overload injury decreased to a slightly lower value for the intervention group. The difference of prevalence of overuse injuries within the intervention group, stratified by the number of executed preventive exercise programs (&lt;2 and ≥2), was significant (p = 0.044). Severity score decreased in both groups during the study. However, there was a tendency to a significant difference between the groups (p = 0.064), where the control group improved slightly more in spite of a higher value when measured at week 8. Shoulder injury and dysfunctions of overhead athletes can be caused by various factors, which means that the riskfactors for each of these conditions may vary. It is therefore important to highlight that the effects of a training program may be different at the individual level compared with the results at group level.

As the work force ages and workers retirement age increases, the number of workers suffering from Work-related Musculoskeletal Disorders (WMSDs) has increased. In a recent study, the U.S Bureau of Labor reported that 6.9% of all WMSDs affected shoulders. Electricians, carpenters, and related construction crafts appear to experience higher incidence of these injuries due the nature of their work that require them often to use Awkward shoulder postures. This research aims to develop a new monitoring system that measure the amount of time workers spend in awkward shoulder postures to help decrease the prevalence of cumulative shoulder injuries and to reduce the number of cases of shoulder WMSDs among construction workers. The monitoring system was designed and a feasibility study was conduct to compare the monitoring system with a state of the art motion tracking system. Overall the monitoring system was able to count the time spent in awkward posture as a discrete state sensor and it can be implemented in the field. However, results showed that the monitoring system in its current configuration require some future work for it to produce quantitatively precise results that can be used in the fields of biomechanics, robotics, and ergonomics.

Author: Bc. Modinat Sanni Supervisor: Ing. Miroslav Vilímek, PhD Title: MUSCLES ACTIVATION DURING "SHOULDER MOUNT"POLE ACROBATIC EXERCISE Purpose: This study is an empirical - theoretical study presents the literature review regarding to the topic of the shoulder function anatomy, kinesiology, biomechanics, non-traumatic injuries of the shoulder and their prevention by using the available literatures. Further, the study also compares by surface electromyography the amplitudes, shapes and durations of myoelectric signals of m. latissimus dorsi, m. pectoralis maior, m. biceps brachii, m. infraspinatus and m. supraspinatus of dominant shoulder in two healthy individuals during acrobatic exercise on vertical pole known as "Shoulder Mount". The purpose was monitor the changes in two different conditions; i.e. kinesiotape and elbow brace and compare with the control condition for the reason of finding out their ability to affect the myoelectric activities of selected muscles. Further, the Shoulder Mount exercise had recorded by six Qualisys cameras for motion analyses. Methods and materials: The potentially eligible scientific articles perform a search of studies on the topic of kinesiotapes and tennis elbow brace as measured by EMG mainly on myoelectric activity of the shoulder complex were seared from...

В диссертационном исследовании рассмотрены причины спортивного травматизма, выявлены часто встречающиеся травмы в волейболе. Разработана комплексная реабилитационная программа при травмах плечевого сустава в волейболе. Сформулированы практические рекомендации, врачам – реабилитологам центров реабилитации, лечебно – профилактических учреждений, которые будут полезны в их работе. / In the dissertation research the causes of sports injuries, identified common injury in volleyball. Designed a comprehensive rehabilitation programme for injuries of the shoulder joint in volleyball. Practical recommendations are formulated, physicians – rehabilitation specialists of rehabilitation centers, medical institutions, which will be useful in their work.

Thesis title: Effect of targeted training of the lower scapular fixators on the shoulder girdle function of rugby players The concept of the problem: Rugby is one of the toughest ball sports and there is no shortage of injuries. In addition, injuries in the shoulder area are among the most common and any possibility of reducing these injuries is beneficial. There is not much time left for compensation and targeted intervention; moreover, it is not usually led by physiotherapists but by fitness coaches and only in larger clubs. The consequence is a muscle imbalance in the shoulder girdle, which can result in the so-called scapular dyskinesis. This is turn affects the function and stability of the shoulder joint not only by the overhead athletes. It is possible to influence scapular dyskinesis in various ways. One of them is the inclusion of targeted training of lower scapular fixators into fitness training and thus their stability is improved. Objectives: The main aim of this thesis is to verify whether rugby players with painful shoulder have sufficiently scapular fixation based on kinesiological and biomechanical knowledge. Another aim of this thesis is to create such an exercise unit that would ensure the correct activity of the lower scapular fixators and verify this by measurement. The final...