Association Between Hip Range of Motion and Abductor Strength with Upper Limb Injury in Racket Sport Athletes
Description
The aim of this study was to investigate whether hip rotational range of motion and isometric hip abduction strength are associated with a history of upper limb injury in adult racket sport athletes. The primary finding of this study was that a greater imbalance between dominant side hip external rotation and internal rotation range of motion at 90° of hip flexion was associated with a history of upper limb injuries in racket sport athletes. Both univariate and multivariate analyses supported this, with each 1° increase in ER ROM relative IR ROM associated with a 7% increase in injury likelihood. This suggests that even small asymmetries in hip rotational profile may have meaningful implications for injury risk.
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Participants Forty-one participants (n = 41) were recruited. Inclusion Criteria: Adults aged 18-40 who had at minimum participated in organised training and/or competitive matches for 3 hours per week in a racket sport for the previous 12 months. Included racket sports were tennis, badminton, squash, pickleball and padel. Exclusion Criteria: Acute hip injury at time of testing or history of hip injury within the past 3 months that would give inaccurate representation of baseline hip ROM and strength measurements. Injury History Injury to the upper limb was limited to the shoulder and elbow. Injury was defined as “tissue damage or other derangement of normal physical function due to participation in sports, resulting from rapid or repetitive transfer of kinetic energy” in accordance with International Olympic Committee recommendations on injury epidemiology studies (Bahr et al., 2020, p. 374). Upper limb injury history was assessed by a questionnaire following the same guidelines. It captured information pertaining to their playing volume, injury occurrence, time lost from sport due to injury and other relevant information. See Appendix A for the full questionnaire. This was completed after obtaining objective hip measurements to reduce risk of bias. Injury Classification All reported injuries were classified using the Orchard Sports Injury and Illness Classification System (OSIICS, Version 15). This standardised approach ensured comparability with existing literature and accurate grouping of injury types for analysis. Outcome Measures All measurements were taken bilaterally and carried out by the same practitioner to ensure consistency. Hip range of motion: Passive hip rotation ROM was measured using a “Halo Digital Goniometer” which has been found to be valid and reliable (Correll et al., 2018). This was assessed in supine and prone. For the supine assessment, participants lay on their back with the hip and knee flexed to 90°. The goniometer was placed on the tibial tuberosity and the hip was brought into internal and external rotation. Participants then lay prone with the knee flexed to 90°, the hip was passively taken into internal rotation. “Total rotational arc” of the hip was obtained by adding IR and ER ROM at 90° hip flexion. Conversely, “Hip rotation ROM imbalance” was obtained by subtracting the participants IR ROM from their ER ROM at 90° hip flexion. Isometric hip abductor strength: Isometric hip abductor strength was measured using handheld dynamometry, specifically the “MicroFET 2” and “Lafayette Model 01165” which are valid and reliable models (Espino et al., 2026; Kawaguchi and Babcock, 2010). Testing was completed in supine lying in accordance with standard set by Thorborg et al. (2010). Each test consisted of two maximal 3-5s contractions with 30s rest between each. Peak value (N) was recorded and then normalised to body mass (N/kg), the mean of the two trials was used for analysis.
Institutions
- South East Technological UniversityMunster, Waterford