Sports related shoulder-back injuries and movement control in loaded overarm sports - The effect of movement control-based exercise intervention on shoulder-back injured collegiate weightlifting athletes

The following evaluation will be performed for identifying the situation of risk predictors. 1. Strength: The strength of major muscles in loaded overarm sports, including bilateral biceps brachii, deltoid, trapezius, pectoris major, shoulder external rotator, latissimus dorsi, gluteus maximum, hamstring, quadriceps, hip abductor and hip rotator, will be measured by hand-held dynamometer. 2. Range of motion: All direction of movement in injury-related joints, bilateral shoulder, hip, knee, ankle, and thoracic, lumbar spine, will be measured by goniometer/ inclinometer. 3. Functional movement assessment: Y-balance test for upper limb and functional movement screening (FMS) 4. Kinematics, muscle activation and foot pressure: The kinematic data, muscle activation and foot pressure will be recorded when performing loaded overarm sports. For the kinematic variables, there include joint movement of bilateral shoulder, hip, knee, ankle and thoracic, lumbar spine. The electromyography will measurement in the injured side, which include biceps brachii, deltoid, upper and lower trapizeus, erector spinus, gluteus maximum, quadriceps and semitendinosus. A pair of foot pressure insole will put inside the shoes during test. For improving the movement control, each individual in experimental group will receive a specified one-on-one exercise program. These exercise program are designed based on the results of functional movement assessment, target Borg RPE set as 3, and perform by physiotherapies with 30 minutes per section, twice a week for 12 weeks. For example, the shoulder movement control training, performing dissociation shoulder movement slowly and smoothly, will be assigned for subject who has uncontrolled movement, e.g. cannot just perform the movement in one joint which has some accompany movement in other joint, and pain in shoulder joint. Subjects will be asked to participate at least 20 sections, and sign in an intervention calendar for counting the attending rate. Incident of sports related shoulder-back injuries will be recognized from the interview by physiotherapies per 2 weeks and following up for 24 weeks.

The following evaluations will be performed by well-trained physiotherapists at the initiation of the study and following up, every 2 weeks for 18 weeks, depending on the injury status and risk factors for the sports-related shoulder-back injury. 1. Functional movement assessment: Functional movement screening (FMS) 2. Sports-related shoulder-back injury status: Numeric Pain Rating Scale (NRS) for pain intensity follow-up of individuals' shoulder-back injury pain situation during the training of the passing week. For improving the movement control, each individual will receive a specified one-on-one exercise program. These exercise programs are designed based on the results of functional movement assessment, target Borg RPE set at 3, and performed by a physiotherapist with 15-20 minutes per section, every time before training as a part of warm-up exercise for 6 weeks (2 times a week, 12 times in total). For example, the shoulder movement control training, performing dissociated shoulder movement slowly and smoothly, will be assigned for a subject who has uncontrolled movement, e.g., cannot just perform the movement in one joint, which has some accompanying movement in other joints, and pain in the shoulder joint. Subjects will be asked to sign in an intervention calendar for counting the attendance rate. Incidents of sports-related shoulder-back injuries will be recognized by the physiotherapist every 2 weeks.