Preventive Strategies for Spinal Injury in Youth Handball Players

Abstract

Competitive sport life can be seen as an arena where you must prove the highest abilities and sometimes the impossible of human body. To achieve such competency in a specific sport area takes time, effort and sometimes, at some point in career, an injury. A controversial issue appears to be: how to prevent injuries in sports? This paper underline the role of prevention of wide spectrum of spinal injuries and highlights the inherent weakness of immature spine of youth players that can may be a disadvantage not only for lesions which mirror at young age but also in adults. Youth handball athletes cannot and should not be regarded as adult players. The young athlete’s musculoskeletal system is constantly changing and this can be one of the possible causes of injuries. When different and specific types of forces act on spine with specific limitations in young players, it is very important to maintain a good core stability to protect the spine and its surrounding structures. An injury prevention program have been developed to improve core stability and to reduce sports-related injuries at youth handball players. The specific advantages of a good core stability are discussed in depth with a particular focus on spine injuries prevention.

Keywords: Corestability, handballplayers, injury

Introduction

Particularly, there is a scarcity of information on the prevalence and incidence of spinal injuries, partly due to the resilience of high competition players who always want to train and play so they do not lose their place in the team (Rocha, 2018). Several path mechanism of lower back disorders among athletes have been described that may predict or be susceptible for back pain such as lumbar spondylolysis, facet joint disorders, muscle, fascia and its insertion disorders, lumbar intervertebral disc herniation’s and sacroiliac joint disorders (Kaneoka, 2015).

There is a host of spinal injuries and problems that are associated with competitive sport and the most common condition spinal pain is low back pain (Mitchell et al., 2016). It is known that one of the building blocks which contributes to less frequent of low back pain is physical activity and sport participation. This statement is relevant only until the first time appearance of back pain, once pain occurs, sport activities might increase the persistent, severity of pain and its recurrence (Rocha, 2018). The question remains how can we prevent it from occurring in the first place?

Problem Statement

When the back is submitted to stress forces, the physiology and biomechanical principles that rule general population are the same for handball players (Rocha, 2018). In order to decrease the mechanical stress, it is thought to be essential to maintain the proper spinal alignment and the spinal segmental stability (Kaneoka, 2015). In order to reveal this dynamic entity of low back pain in handball players we must understand the muscles function and their importance for stabilizing the lumbar spine.

The spinal stabilizing system consists in the passive musculoskeletal subsystem which includes vertebrae, facet articulations, intervertebral discs, spinal ligaments, and joint capsules. The second is the active musculoskeletal subsystem which includes the muscles and tendons surrounding the spinal column. The third subsystem is the neural and feed-back subsystem which consist of the various force and motion transducers, located in ligaments, tendons, and the muscles, and the neural control centers (Panjabi, 1992; Studnicka & Ampat, 2021).

The spine provides structural support, enables trunk movement, and protects neural elements (Snyder et al., 2022) but the stiffness allows the spine to support loads and this essential stiffness is what the core muscles provide (McGill, 2017). Thus, the definition of core muscles includes all the attach the pelvis, spine, the ribcage and also those muscles that cross the hips (McGill, 2017).

But why core training is so essential for injury resilience and performance enhancement? The explanation has four components:

• proximal stiffness (meaning the lumbar spine and core) enhances distal athleticism and limb speed;
• a muscular guy wire system is essential for the flexible spine to successfully bear load;
• muscular coactivator creates stiffness to eliminate micro movements in the joints that lead to pain and tissue degeneration;
• abdominal arm or is necessary for people in some occupational, combative, and impact situations (McGill, 2015)

The trunk muscles are important for ensure sufficient stability of the spine against perturbation from external load, sustain postures as well for sustain movement. The trunk muscles were classified into a local and global system in order to better understand how the muscular system acts on the stability of spine. The local muscle system includes the deeper muscles which controls directly lumbar segmental stabilization and have their origin or insertion points either directly or indirectly on the lumbarvertebrae. The global muscle system includes those muscle that do not directly attached to the vertebrae (Bergmark, 1989). Recently, it is suggest that isometric core training is superior to dynamic training for enhancing torso stiffness (Lee & McGill, 2015; Okubo, 2015).

These studies provide information that allows us to propose effective exercises for enhancing co-activation of the local and global muscles and improve the complex coordination of trunk muscles activity for both injury resilience and performance enhancement that is important during sports.

Research Question

Given the information that suggest the importance of local muscle activity in providing stability of the spinal segments, would be beneficial for youth athletes to involve a specific core training in their traditional athletic training program.

The isometric core training program was applied on 16 youth handball players. The McGill torso muscular endurance test battery was used to examine changes in core muscular endurance (Figure 1). All subjects were trained between October 2021 and January 2022 during 3 workout per week. The players were measured before and after 4 month training. After the initial data collecting, the players received a program training based on their specific muscle limitations (Table 1).

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Purpose of the Study

The purpose of this paper is to analyse the effect of four-month isometric core muscular training on core stiffness and endurance in youth handball players.

Research Methods

The research methods was carried out as follows: method of study of specialized literature, method of analysis, method of tests, graphical and table method, statistical-mathematical method.

Findings

A significant improve on trunk muscular endurance was observed after four-month isometric training. After data collected the flexion-extension ratio increased for 8 players, ride side bridge-left side bridge ratio increased for 6 players and side bridge (each side)-extension ratio increased for 5 youth handball players. The results suggest that the isometric training approach enhance core stiffness and muscular endurance and this may allow the spine to bear greater loads. The next step is to examine the incidence of spinal injury in handball players who perform a core muscular training in their traditional training program.

Conclusions

The spinal injury in handball players are mainly influences by dynamic and repetitive nature of sport and the approach to prevent spinal injury in a handball athlete can be a challenge. The isometric core training may have a large impact on the approach to torso muscle training for both prevention spinal injury and performance enhancement.

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