Relationship between Range of Motion and Isometric Shoulder Strength in Elite Team Handball Players.

The study was cross-sectional, so it cannot show whether shoulder pain came before the range of motion or strength differences, or whether the differences came before pain. Only the dominant shoulder was measured, so side-to-side differences and pathological glenohumeral internal rotation deficit could not be assessed. The same physical therapist collected shoulder pain information and performed the tests, so the tester was not blinded to pain status. The handheld dynamometer was held by the examiner and not fixed to a wall or ground, which could affect readings for strong players. The testing position differed from other published protocols, so results may not compare directly with other studies. All testing was done by one examiner, and players from different leagues and countries were tested at different times during the season, when shoulder adaptations may change. The pain group had 34 players and the previous-pain group had 36 players, while the no-pain group was larger. Players had to be active in offensive and defensive play and could not be recovering from a musculoskeletal injury that excluded them from participation for six weeks, so findings may not apply to injured or less active players.

The authors reported no conflict of interest. The paper does not state who funded the work.

Do not conclude that shoulder pain causes lower range of motion in women or higher internal rotator strength in men. Players were grouped by pain history at one time point, the non-dominant shoulder was not measured, and testing was not blinded. The findings describe differences between groups, not causes.