Shoulder girdle injuries in table tennis and their prevention

Namizni tenis je eden izmed najhitrejših športov z žogo na svetu. Igralci med samo igro doživljajo velike napore ter izvajajo ponavljajoče se zahtevne udarce, ki lahko sčasoma privedejo do poškodb preobremenitvenega tipa. Čeprav je pri namiznem tenisu obremenjeno celo telo, pa je najbolj dovzetno področje za razvoj poškodb ramenski obroč, kar dokazujejo tudi pretekle raziskave. Ramenski obroč sestavljajo glenohumeralni, skapulotorakalni, akromioklavikularni in sternoklavikularni sklep. Pasivno stabilnost mu nudijo ligamente strukture, medtem ko aktivno stabilnost zagotavljajo številne mišice. Najbolj dovzetne za poškodbe so mišice rotatorne manšete, ki skrbijo, da je glavica humerusa v dobrem stiku z glenoidno jamico. V primerjavi z drugimi športi z loparji se namizni tenis razlikuje v tem, da med samo igro zelo redko vsebuje udarce nad nivojem glave. Ta položaj je eden izmed najbolj kritičnih, saj je takrat glenohumeralni sklep najmanj stabilen in najbolj dovzeten za poškodbe. Kljub temu, pa se med namiznoteniškimi igralci še vseeno pojavljajo podobne poškodbe ramenskega obroča kot pri badmintonu, tenisu in squashu. Najpogostejše poškodbe, s katerimi se srečujejo so utesnitveni sindrom, tendinopatija rotatorne manšete in deficit v notranji rotaciji glenohumeralnega sklepa. Zakaj tudi pri namiznem tenisu prihaja do podobnih poškodb še ni povsem znano, avtorji pa so mnenja, da to povzročijo kratki, hitri, agresivni udarci, predvsem pri forehandu, ki so za razliko od drugih športov brez faze izmaha. To povzroča »mikropoškodbe« v tetivah in mišicah kar sčasoma privede do poškodbe. Ramenski obroč je največkrat poškodovan predel v namiznem tenisu, zato smo v magistrskem delu s pomočjo zbranih podatkov izoblikovali preventivni program vadbe, ki bi ga bilo smiselno vključiti v trenažni proces. Program sestavljajo vaje za moč, gibljivost hrbtenice ter gibljivost mišic in je primeren za vse namiznoteniške igralce, prav tako pa je z vidika opreme finančno dostopen igralcem in klubom. V prihodnosti bi bilo smiselno redno izvajati ta program in ugotoviti, ali je učinkovit, ali pa morda potrebuje še dodatne izboljšave.Table tennis is one of the fastest ball sports in the world. During the game, players experience extreme exertion when performing repetitve forceful movements, that can eventually lead to overuse injuries. Although the whole body is working when playing, the most susceptible area for the development of injuries is shoulder girlde, as proven by past researches. The shoulder girdle consists of the glenohumeral, scapulothoracic, acromioclavicular and sternoclavicular joints. Passive stability is provided by the ligaments, while active stability is provided by noumerous skeletal muscles. The most susceptible to injury are the rotator cuff muscles, which ensure that the head of the humerus is in good contact with the glenoid fossa. Compared to other racquet sports, table tennis rarley contains movements above the level of the head. This position is one of the most critical ones, because the glenohumeral joint is the least stable and most prone to injury. Despite this, shoulder girdle injuries in table tennis are very similar to those in major racket sports but also the other racket sports such as padel, pickelball, racquetball and others. The most common injuries are impingement syndrome, rotator cuff tendinopathy and glenohumeral internal rotation deficit. It\u27s not yet fully known, why similar injuries also occur in table tennis, but the authors belive the main cause are short, abrupt and rapid movements, particularly in forehand strokes with no swing (follow up) phase. This can cause microtrauma in tendons and muscles which can often lead to injury. The shoulder girdle is the most frequently injured area in table tennis. Therefore in our master\u27s thesis, with the help of collected data, we created a preventive exercise programme that could be implemented in training process. The program consists of strength, spinal flexibility and muscle flexibility exercises that are suitable for all table tennis players, and in terms of equipment used, it is financially accesible to players and clubs. In the future, it would be necessary to implement this program in to training regime to see if it is effective or if it still needs further improvement