Elena Seminati

Overuse in volleyball training/practice: A review on shoulder and spine-related injuries

Abstract Overuse injuries are predominant in sports involving the repetition of similar movements patterns, such as in volleyball or beach volleyball, and they may represent as much a problem as do acute injuries. This review discusses the prevalence of two of the most common overuse-related injuries in volleyball: shoulder and back/spine injuries. Risk factors and the aetiology of these injuries are illustrated in order to make possible to initiate preventive programme or post-injuries solutions. Data collected from literature showed a moderately higher injury rate for overuse shoulder injuries compared to the back/spine (19.0±11.2% and 16.8±9.7%, respectively). These data could be underestimated, and future epidemiological studies should consider overuse injuries separately from the others, with new methodological approaches. In addition to age, biomechanical and anatomical features of a volleyball technique utilised in game and the amount of hours played are considered as the main risk factors for overuse upper limb injuries, both for professional and recreational athletes. Together with post-injuries solutions, great importance has to be placed on preventive programmes, such as preventive rehabilitation, stretching, adequate warm up, strength-power exercises, etc. Furthermore, it is particularly suggested that coaches and players work together in order to develop new game/training techniques that minimise stresses and range of motion of the principal anatomical structures involved, while maintaining athletes performance.

The cost of transport of human running is not affected, as in walking, by wide acceleration/deceleration cycles.

Although most of the literature on locomotion energetics and biomechanics is about constant-speed experiments, humans and animals tend to move at variable speeds in their daily life. This study addresses the following questions: 1) how much extra metabolic energy is associated with traveling a unit distance by adopting acceleration/deceleration cycles in walking and running, with respect to constant speed, and 2) how can biomechanics explain those metabolic findings. Ten males and ten females walked and ran at fluctuating speeds (5 ± 0, ± 1, ± 1.5, ± 2, ± 2.5 km/h for treadmill walking, 11 ± 0, ± 1, ± 2, ± 3, ± 4 km/h for treadmill and field running) in cycles lasting 6 s. Field experiments, consisting of subjects following a laser spot projected from a computer-controlled astronomic telescope, were necessary to check the noninertial bias of the oscillating-speed treadmill. Metabolic cost of transport was found to be almost constant at all speed oscillations for running and up to ±2 km/h for walking, with no remarkable differences between laboratory and field results. The substantial constancy of the metabolic cost is not explained by the predicted cost of pure acceleration/deceleration. As for walking, results from speed-oscillation running suggest that the inherent within-stride, elastic energy-free accelerations/decelerations when moving at constant speed work as a mechanical buffer for among-stride speed fluctuations, with no extra metabolic cost. Also, a recent theory about the analogy between sprint (level) running and constant-speed running on gradients, together with the mechanical determinants of gradient locomotion, helps to interpret the present findings.

Anatomically Asymmetrical Runners Move More Asymmetrically at the Same Metabolic Cost

We hypothesized that, as occurring in cars, body structural asymmetries could generate asymmetry in the kinematics/dynamics of locomotion, ending up in a higher metabolic cost of transport, i.e. more ‘fuel’ needed to travel a given distance. Previous studies found the asymmetries in horses’ body negatively correlated with galloping performance. In this investigation, we analyzed anatomical differences between the left and right lower limbs as a whole by performing 3D cross-correlation of Magnetic Resonance Images of 19 male runners, clustered as Untrained Runners, Occasional Runners and Skilled Runners. Running kinematics of their body centre of mass were obtained from the body segments coordinates measured by a 3D motion capture system at incremental running velocities on a treadmill. A recent mathematical procedure quantified the asymmetry of the body centre of mass trajectory between the left and right steps. During the same sessions, runners’ metabolic consumption was measured and the cost of transport was calculated. No correlations were found between anatomical/kinematic variables and the metabolic cost of transport, regardless of the training experience. However, anatomical symmetry significant correlated to the kinematic symmetry, and the most trained subjects showed the highest level of kinematic symmetry during running. Results suggest that despite the significant effects of anatomical asymmetry on kinematics, either those changes are too small to affect economy or some plastic compensation in the locomotor system mitigates the hypothesized change in energy expenditure of running.

Shoulder 3D range of motion and humerus rotation in two volleyball spike techniques : injury prevention and performance

Repetitive stresses and movements on the shoulder in the volleyball spike expose this joint to overuse injuries, bringing athletes to a career threatening injury. Assuming that specific spike techniques play an important role in injury risk, we compared the kinematic of the traditional (TT) and the alternative (AT) techniques in 21 elite athletes, evaluating their safety with respect to performance. Glenohumeral joint was set as the centre of an imaginary sphere, intersected by the distal end of the humerus at different angles. Shoulder range of motion and angular velocities were calculated and compared to the joint limits. Ball speed and jump height were also assessed. Results indicated the trajectory of the humerus to be different for the TT, with maximal flexion of the shoulder reduced by 10 degrees, and horizontal abduction 15 degrees higher. No difference was found for external rotation angles, while axial rotation velocities were significantly higher in AT, with a 5% higher ball speed. Results suggest AT as a potential preventive solution to shoulder chronic pathologies, reducing shoulder flexion during spiking. The proposed method allows visualisation of risks associated with different overhead manoeuvres, by depicting humerus angles and velocities with respect to joint limits in the same 3D space.

Specific tackling situations affect the biomechanical demands experienced by rugby union players

Abstract Tackling in Rugby Union is an open skill which can involve high-speed collisions and is the match event associated with the greatest proportion of injuries. This study aimed to analyse the biomechanics of rugby tackling under three conditions: from a stationary position, with dominant and non-dominant shoulder, and moving forward, with dominant shoulder. A specially devised contact simulator, a 50-kg punch bag instrumented with pressure sensors, was translated towards the tackler (n = 15) to evaluate the effect of laterality and tackling approach on the external loads absorbed by the tackler, on head and trunk motion, and on trunk muscle activities. Peak impact force was substantially higher in the stationary dominant (2.84 ± 0.74 kN) than in the stationary non-dominant condition (2.44 ± 0.64 kN), but lower than in the moving condition (3.40 ± 0.86 kN). Muscle activation started on average 300 ms before impact, with higher activation for impact-side trapezius and non-impact-side erector spinae and gluteus maximus muscles. Players’ technique for non-dominant-side tackles was less compliant with current coaching recommendations in terms of cervical motion (more neck flexion and lateral bending in the stationary non-dominant condition) and players could benefit from specific coaching focus on non-dominant-side tackles.

Validity and reliability of a novel 3D scanner for assessment of the shape and volume of amputees’ residual limb models

Background Objective assessment methods to monitor residual limb volume following lower-limb amputation are required to enhance practitioner-led prosthetic fitting. Computer aided systems, including 3D scanners, present numerous advantages and the recent Artec Eva scanner, based on laser free technology, could potentially be an effective solution for monitoring residual limb volumes. Purpose The aim of this study was to assess the validity and reliability of the Artec Eva scanner (practical measurement) against a high precision laser 3D scanner (criterion measurement) for the determination of residual limb model shape and volume. Methods Three observers completed three repeat assessments of ten residual limb models, using both the scanners. Validity of the Artec Eva scanner was assessed (mean percentage error <2%) and Bland-Altman statistics were adopted to assess the agreement between the two scanners. Intra and inter-rater reliability (repeatability coefficient <5%) of the Artec Eva scanner was calculated for measuring indices of residual limb model volume and shape (i.e. residual limb cross sectional areas and perimeters). Results Residual limb model volumes ranged from 885 to 4399 ml. Mean percentage error of the Artec Eva scanner (validity) was 1.4% of the criterion volumes. Correlation coefficients between the Artec Eva and the Romer determined variables were higher than 0.9. Volume intra-rater and inter-rater reliability coefficients were 0.5% and 0.7%, respectively. Shape percentage maximal error was 2% at the distal end of the residual limb, with intra-rater reliability coefficients presenting the lowest errors (0.2%), both for cross sectional areas and perimeters of the residual limb models. Conclusion The Artec Eva scanner is a valid and reliable method for assessing residual limb model shapes and volumes. While the method needs to be tested on human residual limbs and the results compared with the current system used in clinical practice, it has the potential to quantify shape and volume fluctuations with greater resolution.

On the Estimation Accuracy of the 3D Body Center of Mass Trajectory during Human Locomotion: Inverse vs. Forward Dynamics

The dynamics of body center of mass (BCoM) 3D trajectory during locomotion is crucial to the mechanical understanding of the different gaits. Forward Dynamics (FD) obtains BCoM motion from ground reaction forces while Inverse Dynamics (ID) estimates BCoM position and speed from motion capture of body segments. These two techniques are widely used by the literature on the estimation of BCoM. Despite the specific pros and cons of both methods, FD is less biased and considered as the golden standard, while ID estimates strongly depend on the segmental model adopted to schematically represent the moving body. In these experiments a single subject walked, ran, (uni- and bi-laterally) skipped, and race-walked at a wide range of speeds on a treadmill with force sensors underneath. In all conditions a simultaneous motion capture (8 cameras, 36 markers) took place. 3D BCoM trajectories computed according to five marker set models of ID have been compared to the one obtained by FD on the same (about 2,700) strides. Such a comparison aims to check the validity of the investigated models to capture the “true” dynamics of gaits in terms of distance between paths, mechanical external work and energy recovery. Results allow to conclude that: (1) among gaits, race walking is the most critical in being described by ID, (2) among the investigated segmental models, those capturing the motion of four limbs and trunk more closely reproduce the subtle temporal and spatial changes of BCoM trajectory within the strides of most gaits, (3) FD-ID discrepancy in external work is speed dependent within a gait in the most unsuccessful models, and (4) the internal work is not affected by the difference in BCoM estimates.

Recumbent vs. upright bicycles: 3D trajectory of body centre of mass, limb mechanical work, and operative range of propulsive muscles

ABSTRACT Recumbent bicycles (RB) are high performance, human-powered vehicles. In comparison to normal/upright bicycles (NB) the RB may allow individuals to reach higher speeds due to aerodynamic advantages. The purpose of this investigation was to compare the non-aerodynamic factors that may potentially influence the performance of the two bicycles. 3D body centre of mass (BCoM) trajectory, its symmetries, and the components of the total mechanical work necessary to sustain cycling were assessed through 3D kinematics and computer simulations. Data collected at 50, 70, 90 110 rpm during stationary cycling were used to drive musculoskeletal modelling simulation and estimate muscle-tendon length. Results demonstrated that BCoM trajectory, confined in a 15-mm side cube, changed its orientation, maintaining a similar pattern across all cadences in both bicycles. RB displayed a reduced additional mechanical external power (16.1 ± 9.7 W on RB vs. 20.3 ± 8.8 W on NB), a greater symmetry on the progression axis, and no differences in the internal mechanical power compared to NB. Simulated muscle activity revealed small significant differences for only selected muscles. On the RB, quadriceps and gluteus demonstrated greater shortening, while biceps femoris, iliacus, and psoas exhibited greater stretch; however, aerodynamics still remains the principal benefit.

Estimates of Running Ground Reaction Force Parameters from Motion Analysis

We compared running mechanics parameters determined from ground reaction force (GRF) measurements with estimated forces obtained from double differentiation of kinematic (K) data from motion analysis in a broad spectrum of running speeds (1.94-5.56 m⋅s-1). Data were collected through a force-instrumented treadmill and compared at different sampling frequencies (900 and 300 Hz for GRF, 300 and 100 Hz for K). Vertical force peak, shape, and impulse were similar between K methods and GRF. Contact time, flight time, and vertical stiffness (kvert) obtained from K showed the same trend as GRF with differences < 5%, whereas leg stiffness (kleg) was not correctly computed by kinematics. The results revealed that the main vertical GRF parameters can be computed by the double differentiation of the body center of mass properly calculated by motion analysis. The present model provides an alternative accessible method for determining temporal and kinetic parameters of running without an instrumented treadmill.

TACKLE DIRECTION AND DOMINANT SIDE AFFECT UPPER BODY LOADING DURING RUGBY TACKLES

Background Approximately 25% of Rugby Union injuries occur to players executing a tackle and they mostly involve upper-body regions. Objective To investigate how upper-body biomechanical loading changes depending on the tackle characteristics, such as side of body used and direction of approach. Design A repeated-measures study where a group of Rugby Union players performed full tackling trials against a bespoke tackle simulator. Two conditions (both within-group factors) were analysed: laterality (left/right shoulder) and direction (front/diagonal/lateral) of the tacklers approach. Setting A laboratory-based study. Patients (or Participants) Six male players (26.7±7.6 years, 1.82±0.09 m, 95.7±14.0 kg), all right-side dominant. Interventions (or Assessment of Risk Factors) Participants completed up to 2 dynamic tackles in each of the 6 testing conditions. A 40 kg punch-bag was accelerated manually to simulate the ball carrier and the tackler executed a full tackling movement bringing the punch-bag to the ground. Main Outcome Measurements Peak shoulder impact forces and head linear accelerations were measured through pressure sensors and inertial measurement units. Linear mixed models and magnitude-based inferences were used to assess differences between conditions. Results Dominant (right) shoulder tackles in the frontal direction generated the highest impact forces (5.3±1.0 kN), and overall they were substantially higher (by 15%) than non-dominant (left) shoulder tackles. Impact load decreased going from frontal to diagonal −3%) and lateral tackling (−10%). The lowest peak head accelerations (substantially lower [−5%] compared to frontal tackles) were recorded during diagonal tackles, with the right shoulder (9.1±3.5 g). Conclusions Both laterality (dominant side) and tackle direction have a substantial effect on the loads applied to the upper-body. Where feasible, the tackler should approach from a slightly offset angle from frontal and coaching should aim to reduce the deficiencies in tackling technique on the non-dominant side.