Glenohumeral internal rotation deficit and shoulder injuries

Bolečine v rami pri športnikih, ki zahtevajo mete, udarce ali servis nad ravnino glave so pogoste, razlogov zanje pa je veliko. Do poškodb pride zaradi ekstremnih položajev rame, velikega števila ponavljajočih gibov ter obvladovanja velikih sil za dosego čim boljšega rezultata. Najbolj tvegana je faza zaustavljanja, ko so ekscentrično obremenjeni zunanji rotatorji rame (Kamonseki, Cedin, Habechian, Piccolomo in Camargo, 2018). Zaradi velikega nabora možnosti, ki lahko privedejo do omenjenih bolečin, smo se v tej nalogi osredotočili na pomen gibljivosti notranje in zunanje rotacije rame pri igralcih tenisa. Pridobili smo podatke 73 tenisačev, starih med 10 in 29 let. Vsak je izpolnil vprašalnik, s pomočjo katerega smo dobili splošne podatke (spol, starost, višina, teža, ITM, dominantnost roke), trenažne podatke in podatke o morebitnih poškodbah rame. Vsakemu smo z uporabo elektronskega inklinometra (merilec nagiba) izmerili aktivno maksimalno notranjo in zunanjo rotacijo rame. O poškodbah rame je poročalo 36 (49 %) tenisačev s povprečnim trenažnim stažem 8 let in pogostostjo treningov 6x/teden. V raziskavi smo preverili, ali imajo naši preizkušanci na dominantni strani manjšo notranjo in večjo zunanjo rotacijo, kot na nedominantni strani, kot je to značilno za športe, pri katerih se izvaja mete in udarce nad višino glave, kar smo tudi potrdili. Glavni namen raziskovalne naloge pa je bil ugotoviti, ali je patološki GIRD povezan s težavami v rami in ker več avtorjev definira GIRD različno, smo izbrali tri in jih med seboj primerjali. Prav tako smo želeli preveriti, ali je s poškodbami v rami povezan še kakšen drug dejavnik kot npr. trenažna obremenitev, trenažni staž ter spol. Po opravljeni raziskavi nismo prišli do nobene statistično pomembne povezanosti med pojavnostjo poškodb rame in katerimkoli drugim dejavnikom tveganja zanje. Menimo, da bi lahko dobili drugačne rezultate, če bi zajeli večji vzorec. Ne glede na to smo prepričani, da je treba zaradi kompleksne zgradbe ramenskega obroča v primeru poškodb gledati širšo sliko in upoštevati čim več dejavnikov, ki lahko vplivajo na bolečine oziroma poškodbe rame.Shoulder pain in overhead throwing athletes is common, and there are many reasons for it. Injuries occur due to extreme shoulder positions, a large number of repetitive movements and the control of large forces to achieve the best possible result. The most risky phase is the stopping phase, when the external rotators of the shoulder are eccentrically loaded. Due to the wide range of possibilities that can lead to the mentioned shoulder pains, this research was focused on the importance of the mobility of internal and external shoulder rotation in tennis players. We obtained data from 73 tennis players aged between 10 and 29 years. Each completed a questionnaire to provide general information (gender, age, height, weight, BMI, hand dominance), training data, and data on possible shoulder injuries. The active maximum internal and external shoulder rotation was measured with electronic inclinometer. Shoulder injuries were reported by 36 (49 %) tennis players with an average training experience of 8 years and a training frequency of 6x/week. In the study, we checked whether our subjects had less internal and greater external rotation on the dominant side compared to non-dominant side. This is typical for overhead throwing athletes, which we also confirmed. The main purpose of the research, however, was to determine whether pathological GIRD is associated with shoulder problems, and because several authors define GIRD differently, we selected three and compared them with each other. We also wanted to check whether any other factor, such as training volume, years of tennis practice and gender, is related to shoulder injuries. Our study did not reveal any statistically significant association between the incidence of shoulder injuries and any other risk factors. We think we could get different results if we captured a larger sample. Nevertheless, we are convinced that due to the complex structure of the shoulder girdle, in the event of an injury, it is necessary to look at the bigger picture and take into account as many factors as possible that can lead to pain or shoulder injuries