Finally: Making improvements

These results were necessary for the researcher to develop a preventative strategy. "Ideally, high-level athletes should be evaluated at the beginning of the season, to determine whether they exhibit any weakness in the rotator cuffs," says Bénédicte Forthomme. “In that case, but also in general, a specific training programme and monitoring plan should be established, in order to improve the deceleration strength of the key muscles. This could probably help to prevent a certain number of injuries. This kind of monitored correction programme could be useful for experienced athletes as well as young enthusiasts who want to progress in their chosen sport."

In light of this study, having players undergo isokinetic assessments at the beginning of the season makes perfect sense. However, the scientist insists that morphostatic assessments are useful as well, since they can detect stiffness and imbalances.
This type of approach has already been applied to the lower limbs of professional football players.

Tomorrow is now  

"The Francophone tennis association appreciated our approach, and we have worked with them to conduct preseason isokinetic assessments of their best players. This approach has also benefitted athletes under contract with the Wallonia-Brussels Federation, which named Professor Jean-Louis Croisier (ULg and Liege University Hospital) as the isokinetics expert for its high-level athletes. Indeed, we must continue to raise awareness about these issues and change athletes' practices in order to prevent initial injuries, and then improve monitoring of athletes who have already been injured."

Beyond her study's results, she has another argument to advance her cause: as shown in the article "L'approche préventive de la lésion d'épaule chez le sportif" (“A preventive approach towards shoulder injuries in athletes”), rehabilitation tools exist and are improving – and will continue to do so since shoulders are now the subject of increasing attention and further studies.  For example, scientific research has confirmed the importance of stretching. Some of the potentially damaging adjustments that the shoulder makes during athletic movements could also be taken into account, even during collective training programmes, in order to improve the joint's stability and mobility.  

"We've noticed that clubs and federations are paying increasing attention to prevention and appropriate physical preparation, often in collaboration with physiotherapists. There is definitely an interest in improving the situation,” insists Bénédicte Forthomme.

Match point

Prof. Forthomme's team was able to provide insight into the significance of different intrinsic risk factors for volleyball injuries. But she claims there is still a need to conduct further research (which she is doing, incidentally) and to remain attentive to extrinsic risk factors such as training load, fatigue, equipment, technique, etc. In fact, more research is needed in a number of other areas in order to better understand and prevent sports injuries. "There should be research specifically focused on determining when a player is ready to play after an injury. The results of our study suggest that we also need to look at how previous injuries were managed. Does inadequate treatment of the first injury increase the chance of new injuries or the risk of a re-injury?" the researcher wonders.

While waiting on further scientific advances, Bénédicte Forthomme continues to promote her dual message: the importance of focusing both on performance and injury prevention. "Coaching must address these two aspects," she insists. "We can't forget about injury prevention, and this doesn't only apply to high-level players. Our study shows that we must keep athletes from becoming injured in the first place. Training should seek to reduce risk factors for injury to the greatest extent possible.” We now understand why athletes get hurt, we have the necessary assessment tools, and a number of adapted and personalised training methods and rehabilitation techniques are available. There are also a number of innovative projects addressing these issues, such as the LAMH (Laboratory of Human Motion Analysis), which brings together researchers from the Faculties of Medicine and Applied Science to analyse the biomechanics of athletes' movements. Under these circumstances, it’s entirely within our power to ensure that all games are well played, and less dangerous for the athletes.

(1) Shoulder pain among high-level volleyball players and preseason features, B. Forthomme, V.Wieczorek, A.Frisch, J-M. Crielaard, J-L. Croisier,  published in Medicine & Science in Sports & Exercise ( 45(10),1852-1860,2013), and L'Approche préventive de la lésion d'épaule chez le sportif, B. Forthomme, S. Geizes-Cervera (French Handball Federation), F.Delvaux, J-F.Kaux,  J-M. Crielaard, C. Schwartz , J-L.Croisier (Motor skills, Physical Medicine, and Physiotherapy-Rehabilitation departments at the University of Liege and Liege University Hospital).