gms | German Medical Science

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation, Annual Assembly of the German and the Austrian Society of Physical Medicine and Rehabilitation

Austrian Society of Physical Medicine and Rehabilitation

26.-29.10.2011, Salzburg, Austria

The martial arts shoulder

Meeting Abstract

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, 26.-29.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11esm107

DOI: 10.3205/11esm107, URN: urn:nbn:de:0183-11esm1078

Published: October 24, 2011

© 2011 Medina et al.
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Outline

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Objective: To describe the arthroscopic findings of the shoulder of elite martial arts athletes.

Material/Methods: Our service has extensive experience in the treatment of high level judokas because the senior authors (WC, BS) are part of the national team staff for the past 15 years. Therefore, we have become a reference for those athletes and directed our attention to this modality. Jiu jitsu is also very popular in our region and with the growing popularity of other martial arts we expanded our attention to the martial arts in general. From July 2007 to October 2009, 49 patients were submitted to 60 arthroscopies of their shoulders. We included the high level martial art competitors that had an indication for shoulder arthroscopy and agreed in participate in this study. There were 9 women and 40 men and the mean age was 29.06 years. All athletes were black belt degree (national and international level). Exclusion criteria were acute or previous infection of the shoulder joint or surrounding joints (acromioclavicular, sternoclavicular) or systemic infection; acute or previous fractures of the clavicle, scapula or humerus.

Results: There were 13 jiu-jitsu athletes, 1 krav maga, 1 MMA (mixed martial arts) fighter and 34 judokas. The findings reported during arthroscopy were 32 Bankart lesions (Figure 1a [Fig. 1]) and 1 bony Bankart (Figure 1b [Fig. 1]), 18 chondral lesions being 9 on the glenoid (Figure 1c [Fig. 1]) and 9 on the humeral head (Figure 1d [Fig. 1]), 13 rotator cuff tears (8 supraspinatus, 5 subscapularis), 13 SLAP lesions and 8 Hill-Sachs lesion. Patient characteristics and other surgical findings are summarized in Table 1 [Tab. 1] and Table 2 [Tab. 2].

Conclusion: Nowadays the constant need for high performance among high level competitive athlete has led to serious consequences to physical and psychological aspects of these competitors. Knowing the incidence of most frequent injuries, as well as its possible causes is very important for planning treatment and implementing preventive measures, contributing to increase athletic performance. Martial arts, as other competitive sports, requires strength, velocity, endurance, ability and agility; therefore injuries are inevitable for those who practice this modality. Sports which submit its practitioners to high intensity of impacts during falls with high rates of repetitions, as occurs with falls on combat sports, are among the modalities that results in higher injury rates in athletes that practice periodically. The mechanical impact to the body of these athletes depends upon how the load is applied, its intensity and frequency, and the individual susceptibility that varies with phenotype and the body region subjected to such a load. The injury rates for judo is one of the higher among all sports [1], [2], [3]. The literature reports on acute injuries, lacking works on chronic overload injuries. In this work we found that the most common injury pattern was Bankart lesion (20,5%), due to the increased frequency of shoulder dislocations among judokas [2], [4]. The second most common injury was chondral lesion (11.5%), affecting equally the glenoid and the humeral head. As previous authors have reported with throwing athletes, we believe that martial arts athletes develop a certain pattern of shoulder injuries due to the sport impact. Each modality, with its specific biomechanical characteristic, develops a particular kind of injury to certain anatomical parts of the athlete’s body. There are many reports in the literature regarding the shoulder of throwing athletes and there are some reports on swimmer’s shoulder pathology [5]. The understanding of shoulder joint pathology has improved with the use of arthroscopy, and as seen in this study the “wrestler’s shoulder” is characterized by a Bankart lesion resulting in anterior instability of the glenohumeral joint. The athlete further compensates this lack of stability with posterior translation of the humeral head, which leads to increase overload on the glenoid and humeral head cartilage resulting in the pattern described in this work. Further studies are needed to better characterize the biomechanics and pathoanatomy of these injuries.


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