National-wide implementation of injury preventative strategies in adolescent handball

Title

The Swedish Handball Cohort – National-wide implementation of injury preventative strategies in adolescent handball

Background

Handball is the fourth biggest sport in Sweden with over 32,000 players aged 13-19, and 36 handball-profiled high schools accredited by the Swedish handball federation, app 1200 students. Handball is one of the most injury prone sports, and shoulder, knee and ankle injuries are dominant. Moreover, handball is when of the sports with the highest incidence of anterior cruciate ligament (ACL) injuries. Recent studies have showed that by performing the neuromuscular training program Knäkontroll, the rate of knee injuries in adolescent handball, football and floorball players football players can be significant reduced. Moreover, a recent study performed by our research group showed that the risk of shoulder injury can be reduced by half in adolescent handball by regularly performing the Shoulder Control Programme (Axelkontroll), a training program aiming to increase shoulder strength, shoulder mobility and trunk stability.

Purpose

The overall aim with this cohort study is to investigate the occurrence of handball related injuries, with a special focus on shoulder and knee injuries and sports related concussion, in adolescent elite female and male handball players in the short and long term. Further, the aim is to investigate the knee and shoulder injury rate prior and after implementing the injury prevention trainings programs Knee Control and Shoulder Control and to evaluate the association between injuries during the high school period and future musculoskeletal problems.

Methods

This ongoing prospective cohort study, which started in 2020, has so far included over 1900 players. At baseline the players answered a comprehensive questionnaire involving questions regarding sex, playing position, playing level, playing experience, current injuries and history of injuries, sleeping and nutrition habits, an athletic identity score (AIMS) and compliance to any injury prevention training program. The players are then monitored by weekly reports during their high school years regarding match- and training amount, sleep, workload, and injuries. When the players graduate, they will fill in a questionnaire each year for ten years regarding musculoskeletal problems and if they still play handball and if so at which level.

Significance

Handball is one of the most injury-prone sports and preventative strategies are highly warranted. This study will evaluate the implementation of a national-wide injury prevention program in adolescent handball and investigate the long-term effect of sports injuries during adolescence.

Research principle

Sophiahemmet University

Funding

Swedish Research Council for Sport Science, Sophiahemmet foundation, Scandinavian College of Naprapathic Manual Medicine, Swedish Naprapath Association.

Contact

PhD Martin Asker – Primary Investigator, Head of Handball Research Group, martin.asker@shh.se
Professor Eva Skillgate – Research group leader of Musculoskeletal & Sports Injury Epidemiology Center, eva.skillgate@shh.se