Handball Sports Medicine

Lior Laver • Philippe Landreau Romain Seil • Nebojsa Popovic Editors

Basic Science, Injury Management and Return to Sport Editors Lior Laver Philippe Landreau Department of Trauma and Orthopaedics Department of Surgery University Hospitals Coventry and Aspetar - Orthopaedic and Sports Warwickshire Medicine Hospital Coventry Doha UK Qatar

Romain Seil Nebojsa Popovic Clinique d’Eich Aspetar - Orthopaedic and Sports Centre Hospitalier de Luxembourg Medicine Hospital Clinique d’Eich Weill Cornell Medical College Luxembourg Doha Luxembourg Qatar

ISBN 978-3-662-55891-1 ISBN 978-3-662-55892-8 (eBook) https://doi.org/10.1007/978-3-662-55892-8

Library of Congress Control Number: 2018941839

© ESSKA 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Printed on acid-free paper

This Springer imprint is published by the registered company Springer-Verlag GmbH, DE part of Springer Nature The registered company address is: Heidelberger Platz 3, 14197 Berlin, Germany A Word from the ESSKA President

ESSKA’s mission is to raise the level of care and achieve excellence in the field of orthopedics in Europe, especially in sports medicine and degenerative joint diseases with the intention to improve musculoskeletal function and quality of life of patients. Following this strategy, ESSKA and its newly cre- ated sports-medicine section ESMA intend to stimulate the dissemination of science to improve the health of athletes. ESSKA is proud to publish this book on handball medicine and science in its own book publishing portfolio. To the best of my knowledge, this is the first of its kind in handball and together with a book on football medicine edited by Prof. Jon Karlsson and coworkers in the same collection is part of some of the first sports-specific medical books on the publishing market. This reflects not only the increasing specialization of the sports themselves but also the growing sports-specific medical and scientific knowledge in these fields. The fact that the books are edited by orthopedic surgeons did probably not happen by accident. Despite the best surgical treat- ments we can offer, our community is too often confronted with situations of difficult decision-making after sports injuries, injury-related premature end of careers, or long-term physical or social consequences of sports injuries. Therefore, I felt enthusiastic when Lior Laver approached me in 2014 at the ESSKA congress in Amsterdam to help him publishing a book on handball medicine and science. Ten years before, the massive problem of noncontact anterior cruciate ligament injuries sustained in handball had been brought up by our Norwegian friends led by Grethe Myklebust, Lars Engebretsen, and Roald Bahr [1]. They taught us that about half of these injuries could poten- tially be prevented by adequate prevention training. But little had changed on the handball field. Prevention exercises were still not routinely implemented in practice, and we orthopedic surgeons continued to see too many of these young patients with severe handball injuries. With the exception of Norway and some other rare places, systematic research on handball injuries was sparse until recently. One of these places was Qatar, where to the best of my knowledge the first scientific meeting on handball injuries was organized during the men’s world championship early 2015. Under the leadership of Philippe Landreau and the Olympic gold medal winner of the first ever indoor Olympic handball tournament Nebosja Popovic, a large community of medical and scientific specialists with a particular interest in handball came together for a very fruitful 2-day exchange. Philippe and Nebosja developed similar plans to publish a book on medical aspects in handball. I thank them for having agreed to join us as coeditors in a single book project under the aegis of ESSKA.

v vi A Word from the ESSKA President

Handball is one of the pivoting team sports where players are mostly affected by injuries [2]. In comparison to other sports, it can be found in the top five in terms of the number and gravity of injuries. Concussions are not rare, as are acute joint injuries, mostly of the knee and ankle, and recent studies have emphasized the importance of overload and degenerative injuries, especially of the shoulder, hip, and knee. Further research is needed to assess the magnitude of these problems, to develop preventive strategies, and to update guidelines on player safety and medical support. Despite some of the existing quality research based on handball players, the sport is lagging behind other sports when it comes to producing evidence-based medicine and science. There is lack of consistent and continuous epidemiologic data research which is necessary to improve the players’ safety in an ever-chang- ing sport environment. At the highest levels, combining national and international competitions, players play up to 80 competitive matches per year at high intensity, with plans to even increase these numbers. Recently, the EHF has recognized the growing need to protect athletes’ health. It has launched a medical and science group, aiming to identify and target immediate needs in order to improve the science in the sport as well as the medical aspects and the players’ safety. It started a unique cooperation with ESSKA. Indeed, it is rare that the stakeholders of a European sports federation join forces with a scientific medical society to improve their players’ health. Therefore, I thank the leadership of the EHF, and especially Mr. Helmut Höritsch, for their willingness to engage in this endeavor. I do also thank my coeditors of which Lior Laver was the main driving force throughout the entire process and the authors, many of whom are highly recognized specialists in their respective fields, for taking their rare spare time to share their knowledge with us in this book project. In some years from now, it can be expected that the medical aspects around handball will be as thoroughly organized as in football and that the science emerging from this improved structure will be beneficial for both the sport and the players’ health in the short and long run. Motivated by the numerous injuries my former teammates and I had sustained during our own handball careers, I performed one of the first epidemiological studies in handball as a young resident in orthopedic surgery [3]. Therefore, I am proud to be part of the editors’ team of this book which hopefully may be beneficial to preserve or improve the health of other players.

Romain Seil

References

1. Myklebust G, Engebretsen L, Braekken IH, Skjolberg A, Olsen OE, Bahr R. Prevention of anterior cruciate ligament injuries in female team handball players: a prospective intervention study over three seasons. Clin J Sport Med.2003; 13:71–78 A Word from the ESSKA President vii

2. Seil R, Laver L, Landreau P, Myklebust G, Waldén M. ESSKA helps making a change: the example of handball medicine. Knee Surg Sports Traumatol Arthrosc. 2017. doi:10.1007/s00167–4478-x. 3. Seil R, Rupp S, Tempelhof S, Kohn D. Sports injuries in team handball: a one-year prospective study of sixteen men’s senior teams of a superior nonprofessional level. Am J Sports Med. 1998; 26:681–687 Foreword by Michael Wiederer

As the game of handball has developed tremendously in recent years, it became evident that a structured and organized medical and scientific support for the game is needed, as well as the establishing of a continuous and pro- ductive communication between the medical and scientific aspects and the rest of the stakeholders around the game. In 2011, the first European Handball Federation (EHF) Scientific Conference was organized by the European Handball Federation on the fringes of its 20th anniversary based on an initiative by Frantisek Taborsky, the former EHF Methods Commission Chairman, who also founded the EHF Union of University Handball Teachers (UUHT). The range of the scientific presentations was wide, including approaches from training sciences, human sciences, and sports medicine. A quote by my predecessor and honorary EHF President, Jean Brihault, paved the way for the successful biannual continuation of EHF Scientific Conferences: Sport, in general, and handball, in particular, needs to steep its roots in the fundamental soil of scientific knowledge, in order to progress in a con- trolled and responsible way towards the higher levels of performance in full respect of the individual performance. The second edition followed in 2013, with a focus on women’s handball. This edition also launched a medical symposium focusing on knee injuries in women’s handball, receiving great attention. In 2015, the third edition was fully dedicated to medical aspects of training and the game, touching on topics such as injury prevention and prophylactic training. That was only possible by the “priceless” input and support of ESSKA (European Society of Sport Traumatology, Knee Surgery and Arthroscopy) that had taken over the patronage of the conference in Bucharest (Romania), namely, Romain Seil (Luxembourg) and Lior Laver (Israel). This was the start of a unique and fruitful collaboration with ESSKA, a loyal sup- porter of handball and handball medicine and a natural partner to the EHF in Europe in the field of sports medicine and sports science. Since then the ESSKA support of handball has helped to spread the medical and scientific knowledge in handball via many more handball-related medical conferences in Europe, such as in Spain (Barcelona), Sweden (Gothenburg), France (Paris), Luxembourg, and even Scotland (Glasgow). Another important step by the EHF was the establishment of a specialists’ network—The EHF Scientific Network of Specialists—in order to promote

ix x Foreword by Michael Wiederer health sciences in our sport with a unique focus on the player’s environment from the grassroots to the top! The EHF CAN (Competence Academy & Network) led by chairman Helmut Höritsch, along with the EHF Methods Commission led by chairman Jerzy Eliasz, has prepared the fourth edition of the EHF Scientific Conference in Vienna, Austria, in November 2017, with full contributions from the newly formed EHF Scientific Network of Specialists. This book is a great example of the excellent and fruitful collaboration between the ESSKA, the EHF, and the EHF Scientific Network of Specialists. It is indeed a great and unique achievement, first of a kind in our sport and hopefully the first of many, serving not only as a comprehensive source for all medical and scientific personnel supporting handball but also as a true inspi- ration to what great teamwork could achieve. Congratulations to the editors and all the authors for this great work. My personal wish is that we shall succeed in establishing a kind of medical platform of experts contributing to the sport of handball for the sake of the athletes’ health and well-being in the future. In addition, it is our aim that beach handball, a new sport of incredible value within the growing handball family, shall be made a topic of scientific research concerning medical and social aspects in the future. The EHF is both honored and grateful for having a partner like ESSKA helping to accomplish our goals!

Vienna, Austria Michael Wiederer Foreword by Per Renström

The sport of team handball is rapidly growing in popularity and is constantly evolving since it was developed at the end of the nineteenth century in north- ern Europe and Germany. After the rules were established in 1917, the first international games were played during 1925–1930 for men in 1925 and for women in 1930. It is an accepted Olympic sport since 1972 for men and 1976 for women. The game has since then spread widely not the least in the Far East, North Africa, and South America. Lately expansions/extensions such as beach handball, mini-handball, street handball, and even wheelchair handball are rapidly attracting more and more participants worldwide. The International Handball Federation was formed in 1946 and currently includes 209 member federations (201 full members) under six confederations. The game in itself has developed to be a very rapid and demanding sport, with continuous changes in the rules of the game to accommodate this evolution. These changes, along with the growing number of participants, have strengthened the constant need for proper and skillful medical coverage and attention for the team handball players. There is a great need for a relevant and reliable team handball-specific source for prevention and management of injuries and illnesses. This book will without any doubt fill that void. The sport is often referred to as team handball to distinguish it from the individual sport of handball, popular mainly in the United States. This accen- tuates the importance of teamwork in a sport, where all persons involved— the players, the coaches, as well as the logistical team and the medical team—have a great responsibility. This is true not only on the field but off the field as well. Preparing a book for publication is no different and requires a great team effort. A book is as good as the authors chosen to write it. An excellent and passionate team of four experts has come together to realize this much needed project and to edit and produce a unique achievement in the field of team handball, sports medicine, and sports science. The initiative to this book was led by Lior Laver M.D., originally from Israel and currently based in the UK. His extensive experience in team handball comes not only from his roles as a team doctor in handball and as one of the leading founders of the European Handball Federation (EHF) Scientific Network of specialists, but not the least as a professional high-level handball player, playing for the Israeli national team for many years, as well as experience in other European leagues. Coeditor Philippe Landreau, M.D., is a French orthopedic surgeon/sports traumatologist, who also has vast experience in the management of sports injuries in general and handball injuries in specific, taking care

xi xii Foreword by Per Renström of the French women’s handball team from 2004 to 2010 until he left for Qatar, where he is now the Chief of Surgery in Aspetar, one of the leading sports medicine centers in the world. The third editor is Romain Seil, M.D., Ph.D., from Luxembourg, a former handball player with strong roots in handball and handball medicine to this day, who also is an orthopedic surgeon and a leader in the world of orthopedic sports medicine and presently the President of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) as well as a founding member of the EHF scientific platform. The book has been carried out in cooperation with and under the scientific publication umbrella of ESSKA. The fourth and last editor is Nebojsa Popovic, M.D., Ph.D., an orthopedic surgeon, working in Qatar since 2007, previously the Aspetar Acting Chief Medical Officer and currently a senior advisor. Dr. Popovic, apart from his many years of experience as an orthopedic sport medicine expert working with teams at the highest levels, not only in handball, brings a unique perspective from being a player at the top elite level, as a world champion and winner of an Olympic gold medal with the former Yugoslavia in 1972. The goal of the editors has been to find internationally well-known authors well experienced in medical questions in handball. They have been very successful and involved many great and respected sports medicine experts. The resulting content of the book has turned out to be very impressive with 45 chapters in total, covering every sports medicine and sports science aspect related to the game of handball. These include basic science aspects, such as biomechanics and nutrition, as well as physiologic and medical preparations in team handball. The book includes 16 chapters describing injuries, many of them specific to team handball. There are also 10 chapters dealing with prevention, rehabilitation, and preparation. The book also includes special consideration chapters dealing with female and young players, perceptual motor aspects, and antidoping. Finally, there are three chapters dealing with psycho- logic aspects in team handball and their association with injuries—definitely an area of growing interest. In other words, this is a very extensive and impressive book, which provides the most comprehensive educational source not only for team handball medical caregivers and scientists but for all team handball personnel. The book is made easily available and accessible to provide answers in whichever aspect of interest in handball (physicians, PTs, rehabilitation personnel, strength and conditioning trainers and coaches). The authors hope that this source would also serve as a link between the different modalities involved in team handball, creating a common language and improving communication within the team staff and environment. This project is led by a group, who has great passion not only for the game of team handball but also a commitment to produce a book characterized by a high scientific quality and based on long experience of the medical problems of their beloved sport. With the support and collaboration of the ESSKA Publications department, the aim has been to produce a book that would be practical and innovational to improve the medical care in team handball worldwide. This book may well be a good starting point to increase the support for team handball science and improve the medical service across the whole team handball spectrum. The aim of this book is to improve players’ Foreword by Per Renström xiii

safety and medical care in the future in parallel with the rapid evolution of the game. I would like to commend the editors and all involved to a work really well done. Congratulations.

• President ISAKOS—International Society of Arthroscopy, Knee Surgery and Orthopedic Sports Medicine 2003–2005. Vice-president 1999–2003 • Member IOC—International Olympic Committee Medical Commission 1989–2012 • Vice President FIMS—International Federation of Sports Medicine 1990–1998 • Member ATP—Association Tennis Professional and ITF—International Tennis Federation Sport Science and Medicine Commission 1997—present • Honorary Fellowship in the Faculty of Sports and Exercise Medicine in Ireland 2007 and in United Kingdom 2011 • Inducted into the “AOSSM Hall of Fame” by the American Orthopedic Society of Sports Medicine

Stockholm, Sweden Per Renström October, 2017 Foreword by Lars Engebretsen

Protection of the athlete is the responsibility of all of us in sports medicine. As the head of medical science in the International Olympic Committee (IOC), it is a pleasure to see this new book on team handball sports medicine and science initiated by Lior Laver, ESSKA, and the European Handball Federation (EHF). Surveilling the injuries and illnesses during the Olympic Games in London, Beijing, and Rio, it has become clear that team handball is a sport with a high risk of injuries (13–17% of all athletes in Beijing, London, and Rio) (Fig. 1). Although many papers on injury risk and recently on injury prevention exist, no full textbook has been available in this field. ESSKA and the authors should be proud of this new book! The International Handball Federation was formed in 1946 and currently includes 209 member federations (201 full members) under six confederations. The game has since then spread widely not the least in Asia, Africa, and South America. Lately expansions/extensions such as beach handball, mini- handball, street handball, and even wheelchair handball are rapidly attracting more and more participants worldwide. This increase in players’ numbers worldwide, along with the evolution of the game into a fast speed, intense game, brought along an increase in injuries incidence! One of the goals of the International Federations (IF) and the National Olympic Committees (NOC) is to protect the health of the athlete. After having carried out surveillance over the last six Olympic Games and studying the published injury and illness epidemiology from the NOCs, it is evident that some IFs and NOCs are now prioritizing this work. Football, volleyball, swimming, ice hockey, and rugby are leading the IFs with excellent examples, but as this new book on medicine and science in team handball is show- ing, many other federations are following in their path. However, whereas some federations have made considerable resources available for well-published research teams, other federations are relying on researchers with access to grants from universities, national institutes of research, etc. This new book is a great example that excellent results may be obtained when researchers and clinicians worldwide in one International Federation get together and cooperate. Through establishing ten Centers of Excellence, the IOC centers worldwide will provide research to protect the health of the Olympic athletes including team handball. However, the time has come for NOCs and IFs to engage in this area and introduce competitive grants. This will attract the best

xv xvi Foreword by Lars Engebretsen

0% 10% 20% 30% 40%

Cycling-BMX Boxing Cycling-MTB Tsekwondo Water polo Rugby Football Handball Gymnastic - Artistic Weightining Wrestling Hockey Judo Tr iathion Tennis Athletics Diving Badminton Fencing Basketball Volleyball Beach volleyball Gymnastics - Rhythmic Synchronised swimming Cycling - Road Salling Cycling -Track Equestrian Modern pentathion Canoe - Sprint Gymnastics - Trampoline Table tennis Swimming Golf Open-water marathon Archery Shooting All Injuries >1 day Rowing >7 days Canoe - Slaiom

0% 10% 20% 30% 40% Injured athletes (%)

Fig. 1 Proportions of athletes (%) in each sport with injury, injury with estimated time loss >1 day, and injury with estimated time loss >7 days Foreword by Lars Engebretsen xvii

researchers and secure the best protection for our athletes. Research funds are needed for work on the effect of venue and equipment modifications, training facilities and forms, rule changes, and general prevention in specific sports. The IOC surveillance of the Olympic Games has highlighted a few sports with challenges in injury prevention. Surveillance of world championships and world cups has made similar findings—the next step is to propose injury prevention protocols and then test these for their efficiency. Many IFs now have well-functioning medical commissions. It would be beneficial if the medical commissions were represented also on the IF boards. This would emphasize the importance of sports medicine for the athletes and would show the intention of the federation to prioritize work in this field. This book provides good examples of IF work within the handball move- ment. The list of contributors shows a good mixture of experienced clinicians and scientists, and even better: the entire handball world is represented! Additionally, this book highlights that prevention of injuries really works. The 50% reduction in serious knee injuries obtained in Scandinavia and considerable reduction in shoulder injuries as well speak to this fact! This book should take this further!

Lausanne, Switzerland Lars Engebretsen March 2018 Preface

The Handball Sports Medicine Book provides a comprehensive overview of current knowledge on the medical and scientific aspects in handball. It is a “state-of-the-art” book compiling the highest quality experts in the field and covering the entire spectrum around the medical and scientific care of handball players. The opening section discusses basic science topics such as biomechanical and physiologic aspects. The following section provides an overview of the medical preparation perimeter, discussing pre-participation assessment and screening, assembling a medical team, and medical coverage of handball events. Handball injuries and their management are extensively discussed in the third section, followed by the fourth section which focuses on injury prevention, rehabilitation, and preparation. The fifth section is dedicated to special consideration topics, such as the female player, the adolescent population, load management, doping issues, and even perceptual skills. The sixth and final section deals with psychological aspects in handball and their influence on the game. This project hopes to affect a wide spectrum of health professionals and scientists, providing not only a source of knowledge but also stimulating and steering further scientific work and research. It will serve as a reference in the field of sports medicine, orthopedics, physiotherapy, and sports sciences. Writing a high-quality scientific book is a challenging and demanding task. Choosing the right team for this task is crucial for its success. We can proudly say that apart from the fact that this book was written by world- renowned experts and leaders in their individual fields, all the authors brought a unique and unlimited passion to this project, which is evident in the book. We would like to thank all the authors for their time and efforts invested in this book, as well as the great passion and enthusiasm they added. This has been produced in cooperation with the European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), and we would like to thank the ESSKA board for accepting the project in its book portfolio, the ESSKA publications team, and the ESSKA office for their support. We would like to extend special thanks to Jon Karlsson, the editor-in- chief of the KSSTA Journal (the journal of ESSKA) and leader of the KSSTA editorial group, for his great support and assistance. In addition to this, we would like to thank the Luxembourg Institute of Orthopaedics, Sports Medicine and Science (LIROMS) for the support in this project. As editors, we hold a great responsibility to the wide spectrum of our target readers, to the authors in this book, to our profession, and to the sport of

xix xx Preface handball—to ensure this book is at the highest standards and that it portrays the great and excellent work invested in it. We would also like to thank our personal teams for their support. We are grateful for the help received from the European Handball Federation and Aspetar - Orthopaedic and Sports Medicine Hospital, the International Handball Federation Reference Centre for Athlete and Referee Health. Last but not least, we would like to express our special gratitude to our families and their endless support and sacrifice allowing us to complete this task with the intended excellence. This book brought many people together, from all ends of the “handball spectrum,” to contribute and create an amazing scientific source for handball and sports medicine. We truly hope this would only be the starting point, lay- ing the foundations of a strong network of all health and science professionals around handball and leading to many future initiatives and projects aimed to improve this amazing sport.

Coventry, UK Lior Laver Doha, Qatar Philippe Landreau Luxembourg, Luxembourg Romain Seil Doha, Qatar Nebojsa Popovic Contents

Part I Basic and Applied Sciences

1 Physical Characteristics of the Handball Player...... 3 Ronnie Lidor and Gal Ziv 2 On-Court Physical Demands and Physiological Aspects in Elite Team Handball...... 15 Lars Bojsen Michalsik 3 Endocrinological Aspects in Handball...... 35 Alon Eliakim and Dan Nemet 4 The Shoulder Profile in Team Handball...... 47 Georg Fieseler, Kevin G. Laudner, Souhail Hermassi, and Rene Schwesig 5 Biomechanical Aspects in Handball: Lower Limb ...... 61 Mette K. Zebis and Jesper Bencke 6 Throwing Biomechanics: Aspects of Throwing Performance and Shoulder Injury Risk...... 69 Jesper Bencke, Roland van den Tillaar, Merete Møller, and Herbert Wagner 7 Nutrition and Hydration for Handball...... 81 Jorge Molina-López and Elena Planells

Part II The Handball Medical Perimeter/Medical Preparation and Aspects

8 Assembling a Medical Team: The Medical Needs of a Handball Team...... 105 Celeste Geertsema, Nebojsa Popovic, Paul Dijkstra, Lior Laver, and Markus Walden 9 The Role of Pre-Participation Assessment (PPA) and Screening in Handball...... 115 Stephen Targett, Tone Bere, and Roald Bahr 10 Medical Coverage of Major Competitions in Handball . . . . 125 Katharina Grimm, Nebojsa Popovic, and Pieter D’Hooghe

xxi xxii Contents

Part III Handball Injuries

11 Handball Injuries: Epidemiology and Injury Characterization: Part 1...... 141 Lior Laver, Patrick Luig, Leonard Achenbach, Grethe Myklebust, and Jon Karlsson 12 Handball Injuries: Epidemiology and Injury Characterization: Part 2...... 155 Lior Laver, Patrick Luig, Leonard Achenbach, Grethe Myklebust, and Jon Karlsson 13 Head and Neck Injuries in Handball ...... 167 Markus Wurm and Lior Laver 14 Shoulder Injuries in Handball...... 177 Philippe Landreau, Matthias A. Zumstein, Przemyslaw Lubiatowski, and Lior Laver 15 Shoulder Instability in Handball Players...... 197 Lior Laver, Przemyslaw Lubiatowski, Matthias A. Zumstein, and Philippe Landreau 16 Elbow Injury in Handball: Overuse Injuries...... 217 Nebojsa Popovic 17 Wrist and Hand Injuries in Handball...... 227 Lionel Pesquer and Grégoire Chick 18 Hip, Groin, and Abdominal Injuries in Handball...... 243 Per Hölmich, Lasse Ishøi, Markus Wurm, Omer Mei-Dan, and Lior Laver 19 Knee Injuries in Handball...... 261 Philippe Landreau, Lior Laver, and Romain Seil 20 Management of ACL Injuries in Handball...... 279 Romain Seil, Eric Hamrin Senorski, Philippe Landreau, Lars Engebretsen, Jacques Menetrey, and Kristian Samuelsson 21 Management of PCL Injuries in Handball...... 295 Markus Waldén and Lior Laver 22 General Aspects of Sports in Adolescents with a Special Focus on Knee Injuries in the Adolescent Handball Player...... 307 Romain Seil, Lars Engebretsen, Jacques Menetrey, and Philippe Landreau 23 Management of Cartilage Injuries in Handball...... 325 Renato Andrade, Rogério Pereira, Ricardo Bastos, Cátia Saavedra, Hélder Pereira, Lior Laver, Philippe Landreau, and João Espregueira-Mendes Contents xxiii

24 Foot and Ankle Problems in Handball...... 341 Pieter D’Hooghe, Jean-Francois Kaux, Bojan Bukva, Nasef Abdellatif, Helder Pereira, Mike Carmont, and Jon Karlsson 25 Management of Chronic Ankle Instability in the Handball Player ...... 355 Pietro Spennacchio, Mike Carmont, Pieter D’Hooghe, Jon Karlsson, Manuel J. Pellegrini, and Hélder Pereira 26 Management of Cartilage Injuries of the Foot and Ankle in Handball ...... 365 Mike Carmont, Martin Hägglund, Helder Pereira, Pieter D’Hooghe, Manuel J. Pellegrini, and Jon Karlsson 27 Back Injuries and Management of Low Back Pain in Handball...... 375 Rui Rocha 28 Osteoarthritis in Handball Players...... 387 András Tállay, Romain Seil, and Lior Laver

Part IV Prevention, Rehabilitation and Preparation

29 Injury Prevention in Handball...... 403 Grethe Myklebust, Mette K. Zebis, and Stig H. Andersson 30 Implementing Handball Injury Prevention Exercise Programs: A Practical Guideline...... 413 Merete Møller, Eva Ageberg, Jesper Bencke, Mette K. Zebis, and Grethe Myklebust 31 Rehabilitation of Upper Extremity Injuries in the Handball Player...... 433 Ann Cools, Rod Whiteley, and Piotr Krzysztof Kaczmarek 32 Shoulder Assessment in Handball Players...... 461 Martin Asker, Rod Whitley, and Ann Cools 33 Rehabilitation of ACL Injury in the Handball Player. . . . . 481 Clare Ardern, Hege Grindem, Joanna Kvist, Markus Waldén, and Martin Hägglund 34 A Biomechanical Perspective on Rehabilitation of ACL Injuries in Handball ...... 493 I. Setuain, J. Bencke, J. Alfaro-Adrián, and M. Izquierdo 35 Rehabilitation of Acute Soft Tissue Injuries of the Foot and Ankle in the Handball Player...... 505 Martin Hägglund, Helder Pereira, Mike Carmont, Jon Karlsson, and Pieter D’Hooghe xxiv Contents

36 Physical Training in Team Handball...... 521 Antonio Dello Iacono, Claude Karcher, and Lars Bojsen Michalsik 37 Stretch-Shortening Cycle Exercises in Young Elite Handball Players: Empirical Findings for Performance Improvement, Injury Prevention, and Practical Recommendations...... 537 Urs Granacher, Ruben Goebel, David G. Behm, and Dirk Büsch

Part V Special Considerations

38 The Female Handball Player...... 553 Mette Hansen, Line Barner Dalgaard, Mette K. Zebis, Lasse Gliemann, Anna Melin, and Monica Klungland Torstveit 39 The Young Handball Player...... 571 Leonard Achenbach 40 Training Load Issues in Young Handball Players...... 583 Martin Asker and Merete Møller 41 Perceptual Expertise in Handball...... 597 Jörg Schorer, Josefine Panten, Judith Neugebauer, and Florian Loffing 42 Doping in Handball...... 615 Kai Fehske and Christoph Lukas

Part VI Psychological Aspects in Handball

43 Psychiatric and Psychological Considerations in Handball Sports Medicine...... 621 Katy Seil-Moreels 44 Decision-Making in Modern Handball...... 627 Peter Weigel 45 Psychological aspects in Handball Injuries ...... 639 Johanna Weber and Manfred Wegner Introduction

The sport of handball, also commonly referred to as “team handball” or “indoor handball,” to distinguish it from the individual sport of handball, is undoubtedly one of the most popular ball sports in the world. This is especially pronounced in Europe, where in many countries handball is one of the top sports in popularity and participation. Although modern handball has only developed in the past century, with indoor handball evolving mostly in the second half of the last century, primi- tive forms of handball were played even in ancient times and persisted in different cultures through the middle ages and on to modern times, especially but not only in European cultures [1]. This continuous link throughout history perhaps helps explain some of the immense and ever-growing popularity of the relatively young game of modern handball as well as the fact that the modern form of the game has developed in Europe, with the “cultural gene” playing an important role. With the evolution and growing popularity of other ball sports (football, rugby, basketball) which developed at that time, it was no surprise that three similar games have evolved almost in parallel at the turn of the last century and are considered the direct ancestors of modern handball: Haanbold—Developed in Denmark by the Danish gym teacher and Olympic medalist Holger Nielsen, with the first written set of rules established in 1898 and published in 1906 [1, 2]. The first known public match took place in 1903 in Denmark. Torball—Developed in Germany by Hermann Bachmann, with a court size similar to the current indoor size (40 × 20 m) and a goal area radius of 4 m [1]. Hazena—The Czech form of handball—Developed in Prague by Vaclav Karas in 1905 and rapidly spread toward the former Yugoslavia area, Ukraine, and Russia. Many characteristics from the game of Hazena were introduced into modern handball, such as a goal area radius of 6 m, while the court size was slightly bigger (45 × 30 m) [1]. These three games have become very popular in Europe over a short period of time, with many local tournaments throughout the continent; however, due to the different rules of each game, it was impossible to organize international competitions. The growing demand and need to unify the rules became evident, and this task was undertaken by Max Heiser, Karl Schelenz, and Erich Konigh from Germany, who published the first modern set of rules in 1917. Karl Schelenz later modified the rules in 1919. The first international

xxv xxvi Introduction games were played under these rules, between Germany and Belgium by men in 1925 and between Germany and Austria by women in 1930, also becoming an Olympic sport in 1936 in Berlin. In its early days, the game of handball or “field handball” was very different from its current form. It was an outdoor game performed on a full-size football field and based on football rules with 11 players on each team, as in football [1]. The first International Handball Federation was established in Amsterdam in 1928 as the “International Amateur Handball Federation (IAHF),” with a German and Austrian leadership in dominance. After World War II, the leadership was taken by the Scandinavians and a new association was reestab- lished in Copenhagen in 1946: the “International Handball Federation” (IHF). The Scandinavian leadership had an important role in the development of the game into the indoor form. Over the years, greatly attributed to the cold weather in Scandinavian countries and to its growing popularity and the demand to facilitate its availability year round, the game of handball evolved substantially since those early days and over the next decades, becoming a primary indoor game. From 1966, world championships were organized only for indoor handball (every 4 years), and this modern, indoor form of “team handball” has finally reemerged as an Olympic sport and into the front world stage in 1972 (Munich) for men and in 1976 (Montreal) for women. Since 1995, the world championships are held every 2 years for both men and women. The European Handball Federation (EHF) was founded in 1991, and European championships are held every 2 years for both men and women since 1994. Continental federations have been founded in other continents since and world and continental championships have been established for all age groups, from the junior to the senior age groups and even master age groups (for retired players). The popularity of modern handball has enjoyed a substantial growth in recent years. In addition, the development of the game’s “siblings,” Beach Handball, Street Handball, and Wheelchair Handball, has helped spread the game even more, reaching out to all layers of the population worldwide. Concurrently with this continual development of team handball and elite sport’s increased focus on performance optimization, significant progress in the game took place with regard to parameters such as technique, tactics and intensity, as well as the physical aspect [3]. Over the years, the professional side of the sport has developed as well, side by side with the evolution of the rules of the game itself, which helped turn it into a fast and very dynamic game, contributing to its attractiveness and growing popularity. At the 2016 Olympic Games in Rio de Janeiro, handball was the second most popular team sport after football. This popularity also enjoys an equal distribution between the men’s and women’s game, which unfortunately is still rarely seen in other sports. These changes have also influenced the physiologic aspects of the game as well as the injury profile in the sport, which emerged as one of the most injury-prone ball sports [4, 5]. The growing need for an appropriate scientific and medical envelope to support the game became evident; however, these aspects lagged behind those provided for other popular ball sports such as football, basketball, and rugby, a fact portrayed quite dis- tinctively in the much lower number of scientific studies and English-language Introduction xxvii

scientific publications in handball compared to these other sports. Despite this discrepancy between the popularity of handball, in terms of participation and media coverage, and the science published on the sport, high-quality scientific research has been done in handball, contributing not only to the sports but providing great scientific merit for other sports as well. The future of handball appears very bright. The IHF now counts 209 national federations among its membership (201 full members, 4 associated members, and 4 regional members) under six confederations, making it one of the biggest international sports federations. The introduction of the new discipline of beach handball, and even the more recent street handball, as well as wheelchair handball, which has opened a window into paralympic sports, is already helping spread the game even more, reaching out to all layers of the population worldwide. Professional leagues for men and women draw thousands of spectators in Europe, Asia, and South America, and apart from the world and continental championships for national teams, competitions such as the European champions league for men and women annually feature the world’s best teams, competing for substantial prize money and international prestige. Finally, the evolution of the game of handball on all its aspects over the last century has made it the exciting, popular sport of current day. Undoubtedly, the next 100 years will bring ongoing evolution; however, the status of handball as one of the most popular and exciting sports worldwide seems to be assured. This book compiles the work of the top international experts in the field of handball medicine and handball science. It is the most comprehensive scientific source to date, aiming to aid and guide medical and all scientific personnel around the sport of handball, and hopefully will be the starting point of many other joint projects aimed to develop the medical and scientific support for the game.

References

1. Playing Handball: A comprehensive study of the game. By Zoltan Marczinka. TRIO Budapest Kiado, 1993 – Hungary. ISBN 978-615-80560-0-7 2. Nielsen H. Vejledning i Haandbold. In: Idrættens Forlag, København, Danmark (eds.). [Guidance in Handball. In: Idrættens Forlag, Copenhagen, Denmark (eds.)], 1906. 3. Andersen B, Larsen E, Nielsen NK, Worm, O. Håndbold i 100 år - et overblik. København: Danmarks Håndbold Forbund, eds. [Team Handball in 100 years - an overview. Copenhagen: Danish Handball Federation, eds.], 1997. 4. Engebretsen L, Soligard T, Steffen K, Alonso JM, Aubry M, Bidgett R, Dvorak J, Jegathesan M, Meeuwisse WH, Mountjoy M, Palmer-Green D, Vanhegan I, Renstrom PA. Sports injuries and illnesses during the London Summer Olympic Games 2012. Br J Sports Med. 2013. 5. Åman M, Forssblad M, Henriksson-Larsén K. Incidence and severity of reported acute sports injuries in 35 sports using insurance registry data. Scand J Med Sci Sports. 2016;26(4):451–62.