FACULTY OF GEOGRAPHY, TURISM AND SPORT DEPARTAMENT OF PHYSICAL THERAPY AND SPECIAL MOTRICITY KINESIOLOGY Coordinator: Lect. Univ. dr. Szabo -Alexi… [603641]

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UNIVERSITY OF ORADEA
FACULTY OF GEOGRAPHY, TURISM AND SPORT
DEPARTAMENT OF PHYSICAL THERAPY AND
SPECIAL MOTRICITY
KINESIOLOGY
Coordinator:
Lect. Univ. dr. Szabo -Alexi Paul Student: [anonimizat] 2018

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Contents

Introduction ………………………….. ………………………….. ………………………….. ……………………… 4
1. The game ………………………….. ………………………….. ………………………….. ………………….. 5
1.1. Motric qualities ………………………….. ………………………….. ………………………….. ……… 6
1.2. Psychic qualities ………………………….. ………………………….. ………………………….. …… 8
2. The risks and injuries ………………………….. ………………………….. ………………………….. …….. 9
2.1. Classification of the injuries by their location ………………………….. ………………………… 9
2.2. Factors and figures ………………………….. ………………………….. ………………………….. ….. 9
2.3. EHF Injury Study ………………………….. ………………………….. ………………………….. …….10
3. Prevention and rehabilitation ………………………….. ………………………….. ……………………… 12
3.1. Factors of prevention ………………………….. ………………………….. ………………………….. .12
3.2. Core stability ………………………….. ………………………….. ………………………….. ………….. 12
3.3. ACL prevention ………………………….. ………………………….. ………………………….. ………. 13
Conclusion ………………………….. ………………………….. ………………………….. ……………………… 14
References ………………………….. ………………………….. ………………………….. …………………….. 15

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Introduction

The purpose of this paperwork is to show the face of sport we do not see everyday. For
this, I choose to focu s on a specific sport: handball, a sportive game in which t wo teams
compete against each other, aiming to put the ball in the other ’s team goal only using their
hands. As it is a sport which allows contact betwee n players, injuries often occur . Therefore,
the content of this study is struct ured into three chapters, each of them focusing on one face
of this game.
First chapter has the role of introducing the handball game, explaining in what it consists,
what kinds of moves and abilities does it take. The focus is put on the motric qualities that
are involved in this sport: skill, speed, force and resistence.
Second chapter presents some of the most common injuries classified by their rate of
appearing, location, severity, time needed for recovery and some factors which can cause
the injuries. This contain some clear figures based on different studies.
Third chapter is about methods of preventing the injuries in both manners: physical and
psychological, with traning the balance and coordination and supervising the mintal state of
the players.

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1. The game

”The handball game is characterized by the formative demand in the development of
the athletes practicing it having a direct fighting character, assuming almost direct contact
between the opponents and being materialized and by intensive solicit ation of the physical
and mental resources, the complexity of the force and the speed of the movements in the
field, the necessity of some reactions , decisions and actions extremely fast and adapted to
concrete situations in constant change, which led to the handball being a sportiv spectacle”.
(Francisc Biro, Handbalul de performanță, 2005, p.12 ) (Fig. 1 , 2)

Fig. 1 – Handball as a sportive spectacle

Fig. 2 – Direct contact between players

According to Hoffman, sport is a „physical activity that place a premium on skill,
strengh, endurance, or other physical qualities and in which one’s performance is assessed
in a relation to a standard or the performance of others”. He also says that competition makes
the physical activity more enjoyable, more i nteresting and improves performances.

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Physical activity is defined by Karl Newell as an ”intentional, voluntary movement
directed toward achieving an identifiable goal” (1990).
The current handball player must have a high degree of development of motor ski lls,
strength -speed, detention, especially skill s and mobility, all of which are needed throughout
the game.

1.1. Motric qualities

Motricity , in opinion of F. Biro, acts through internal factors, recognized in heredity
and great functions, and by external factors such as education and workout. The hereditary
characters can be stable (speed, skill) and labile (resistance, force).
”Skill is the ability to easily do som ething based on the knowledge and experience
accumulated, the ability to coordinate the actions of the whole body or its moving parts in
order to perform the correct motor act on time with a minimum expense of energy and with
optimal efficiency. ” (P. Cerce l, 1975, p.11)
Skill may be general when it involves the acquisition of a wide range of actions, or
specific, characteristic of a particular sport, where the shape of actions is roughly the same.
”In handball, skill is a very important quality that facilit ates the correct acquisition of
the technique and allows motoring action, technical procedures and gameplay to be
performed more easily under varying playing conditions and with increased efficiency.
The condition of the playing field, the ball used, the h andball and climatic conditions
influence the behavior of the teams and players. Skilled is the player who makes good use
of their training, regardless of the circumstances in which they play, irrespective of their
opponent. ” (P. Cercel, 1975, p.15)
”Speed means velocity in movement and execution ” (P. Cercel, 1975, p.33). He says
that t he speed depends on several factors the frequency with which the neuro -motor pulses,
the degree of muscular development, the length of the segments, the sports technique, t he
type of muscle fibers.
Pavel Cercel classifies the speed by their nature in speed of response, decision and
execution.
The r esponse speed is determined by the speed at which different signals received
from the analyzers are perceived. In handball, depen ding on this response speed, there are
elements such as going on the counter, blocking balls thrown at the goal and goalkeeper's
plunger. This reaction rate depends largely on the functioning of the nervous system and the
effectors.
The decision speed lies in the speed with which the driving act to be performed is
made. This action depends on the game and, implicitly, on the reaction speed. In sports
games, including handball, this decision speed is about anticipating the intentions of
teammates and opponen ts. That is why the decision speed increases as the athlete
accumulates a gambling experience.
Execution speed refers to the speed at which a certain motor act is performed and
depends on the degree of acquisition of the required technique and the level of muscle
development. Increased execution speed provides good performance for items such as
catching, birding, throwing at the goal, leading to a qualitative deployment of handball.
In handball, as well as in other sports, the integral speed that combines several forms
of speed together with other factors appears. For example, taking off the counter -attack
involves all the above -mentioned types of speed: reacting to the visual stimulus according to
which the ball entered the team, the decision to go on the counter, the execution of the

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departure, which for optimum performance must be executed after a time shorter. Other
factors such as attention, concentration, fatigue, motivation influence overall speed. (Fig. 3)

Fig. 3 – Speed is a key for the counter -attack

Resistance is, according to P. Cercel, the ability of the body to cope with fatigue,
which allows man to make certain efforts for a long time (1975, p. 56.) . Fatigue can be
intellectual, sensory, emotional, or physical. The degree of resistance depends on the
functional capacity of the body, energy resources, metabolism and influenced by the
technique of movement, the rational request and the psyche of the athlete.
The handball game requires medium and long last ing resistance, but the intensity of
the effort varies over the duration of the game, with players traveling over 4 km.
The structure of the movements and the rhythm of movement constantly change during the
game due to the playing phases. This way you can see different types of running (face, back,
side), sudden turn and stops, steering changes, sprints, all performed at a sustained pace
throughout the game. (Fig. 4 )

Fig. 4 – Resistence is needed due to it being a tough game

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Resistance is the most perfe ctionable skill, and the modern handball game falls into
”the category of high intensity variable effort ”. (P. Cercel, 1975, p. 59). Strength training must
be changed periodically, increasing requirements as the body adapts to new requirements .
”Force is the quality that overcomes the inertia of one's body in a state of rest or
motion. ” (P. Cercel, 1975, p. 71) Strengthens the result of muscle contraction.
He says that t he manifestation of the force is influenced by the cross section of the
muscle, the number of muscles involved, the biochemical composition of the muscles, the
mechanical advantage offered by the levers formed.
In the sport activity there are several forms of manifestation of force: general, used to
solve a wide range of actions and spec ific used in a certain branch of sport.
The handball force consists in the fact that it manifests itself in close connection with
the other driving qualities. At any time, the locomotor is engaged in performing specific
action s. (Fig. 5 )

Fig. 5 – Throw ing uses force

Handball strength education training aims at: qualitative development of muscle
groups that are required in explosive force, in specific detention, in special force, in the force
of failure in upper and lower limbs; developing strength in close relationship with other motor
skills; the harmonious development of the force o f the whole locomotor apparatus, says
Cercel.

1.2. Psychic qualities

Affectivity is appreciated by happy and gentle or closed and aggressive backgrounds.
Will is seen throug h perseverance and helps to overcome fatigue. Intelligence is a complex
function of the brain that determines the athlete's ability to perform complex processes.
Memory is conditioned by attention and concentration and influences skill and other acquired
abilities. Creativity is based on imagination and intuition and gives the game a spectacular
character. Skills , vocation , talent are native, hereditary or acquired abilities.

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2. The risks and injuries

Handball is a sport during which the ball and the players move backwards and forward
at high speed and in which physical contact occurs regularly. The handball game has
changed significantly over recent years . It has become faster and more attractive. This has
also increased the risk of sustaining injurie s.

2.1. Classification of the injuries by their location

Grethe Myklebust classified injuries in:
1. Lower extremity. The majority of acute injuries in handball are located in the lower
extremity, regardless of age and gender. The most frequent injury loca tion reported in
handball is the ankle, while the most serious injuries are knee injuries, including injuries to
the ACL. An ankle injury is usually not very serious; typically an ankle sprain needs only a
few days off from training and matches. In contras t, an ACL injury will require a reconstruction
of the torn ligament for most players. A rehabilitation time of 6 to 12 months is necessary for
these patients to be able to return to their pre -injury activity level.
2. Upper extremities. Acute injuries to the upper extremities are frequent. Shoulder and
hand/ finger injuries are most common . Knowledge of overuse injuries in the upper extremities
is sparse, but a study among German male players showed that 40% of the 25 players
examined had been limited by shoul der pain during training and play during the previous 6
months. The high prevalence of shoulder problems have later been confirmed in a study
among elite female Norwegian players.
3. Head injuries. Some studies have reported a high number of head injuries in top level
handball. It is interesting to note that there seemed to be few concussions among these
injuries, and one might expect that most of these injuries are blows to the face, nose or
possibly teeth.
4. Other types of injury. The most common types of acu te injuries in handball are
muscle and ligament sprains and contusions. Fractures and dislocations are usually less
common. A study aimed to survey elbow problems among handball goalkeepers,
documenting that 41% of 729 players experienced elbow problems. T he injury mechanism
appeared to be repeated hyperextension traumas and the condition was termed ’handball
goalie's elbow’.

2.2. Factors and figures

According to C. Hantău, traumatic risk depends on the intensity at which the handball
game is practiced ( number of hours per week) and on the number of years of practice. Studies
show that there are two major factors: physical involvement and level of attention.

Physical involvement, more or less violent, depends on:
 Sex – women experience less injuries than males
 Level of preparation – more injuries are in lower leagues due to less hours of practice
 Position occupied – wings show a higher traumatic risk

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Level of attention depends on:
 Time of playing – at 7-8 PM the hypoglycemia syndrome occurs
 Number of sub stitutes – increase proportionally with the number of injuries
 Absence of physic contact – absence of an opponent reduce the level of attention

2.3. EHF Injury Study

”Being aware of these problems, the EHF commissioned this study. The aim of the
study was to analyze current data to obtain an overview of the number, type and severity of
injuries and the time players are unable to train and play as a result.” (Hans Holdhaus)
A total of 47 matches were played during the Euro. Thus, a total of 94 reports should
have been handed in. In actual fact, 68 reports were delivered. This is a response rate of
72.3%. The unsent reports were considered as ”clear”.
A total of 53 injuries were reported in connection with matches. The table s below
provides an overview of the injuries that were sustained. (Fig. 8, 9, 10, 11) Hands and fingers
14%
Elbow
5%
Ankle
10%
Knee
7%Other (including
muscles and
tendons)
64%Location of the injuries
Hands and fingers Elbow Ankle Knee Other (including muscles and tendons)
48%
36%
8%
8%Severity of the injury
Contusions
Sprains
Dislocations and fractures
Muscular or tendinous ruprures
and wounds
Fig. 7 – Severity of the injury – datas according to C. Hantău (2011) Fig. 6 – Location of the injury – datas according to C. Hantău (2011)

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Type of injury Number Percent
Contusions 17 32,1%
Muscle strains, muscle contusions 9 17,0%
Ruptures (muscles, tendons) 9 17,0%
Dislocations 1 1,9%
Brain concussion 6 11,3%
Fractures 3 5,7%
Muscle cramps 4 7,5%
Other 4 7,5%
Fig. 8 – Types of injury

Location of the injury Number Percent
Head, neck 13 24,6%
Arm (elbow, shoulder) 6 11,3%
Hand, finger 9 17,0%
Trunk, hip 6 11,3%
Legs (muscle) 11 20,8%
Knee 4 7,5%
Foot 4 7,5%
Fig. 9 – Location of injury

Time Number Percent
1st – 15th min 1st half 8 17,0%
16th – 30th min 1st half 18 38,3%
1st – 15th min 2nd half 10 21,3%
16th – 30th min 2nd half 11 23,4%
Fig. 10 – Time of the injury (missing data)

Injury Number Percent
0 – 1 day 32 60,4%
2 – 7 days 14 26,4%
2 – 25 weeks 7 13,2%
Fig. 11 – Estimated lay -off after the injury

This study was carried by the IMSB -Austria (Institut für medizinische und
sportwissenschaftliche Beratung), which had carried out the men’s study too. The fact that
the figures were somehow alike lead to the conclusion that this pattern is typical for hand ball.
”In 38 cases (71.7%), the injury was preceded by body contact , even if some of them
seamed as they could have been evited . In 21 cases the referees rated this body contact as
foul play. In 7 cases injuries occurred in the absence of any impact from o utside. Excessive
stress was named as the cause in 3 cases (usually muscle cramps). In 3 cases contact wi th
the ball caused the injury, shows the study.” (Hans Holdhaus)

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3. Prevention and rehabilitation

There is a very close relationship between mental state and physical efficiency. The
smallest alteration of the psychoemotional condition can produce a physical dysfunction
manifested in performance, sometimes accompanied by an injury . (Fig. 12) (M. Epuran, 2006,
p. 126) .
3.1. Factors of prevention

Accor ding to C. Hantău, there are two major factors on which coaches have to focus :
improving the technical qualities of players and supervising their level of attention.
Improving the technical qualities of players matters as it is shown that players with a
high technical potential have a low energy consumption compared to technical rudimentary
players. Improving technical qualities results in the avoidance of premature exhaustion of
energy reserves, the immediate consequence being the decrease in the level o f attention .

Fig. 12 – Importance of technique and concentration

The immediate consequence of low level of attention is the inadequate response of
the body to stimuli. The stimuli that can influence the level of attention are two kinds:
peripheral (external) and sensory -sensorial (internal). Thus, due to low levels of attention, the
body receives imprecise or delayed information about muscle tension, joint position,
movement, or type of pain which can immediately cause injuries.
The state of the athlete also comes under the heading of prevention: the physical
condition must be related to the level of practice; physical and mental integrity. Another
aspect that needs to be considered is the condition of the material: sports shoes and in good
condition, the playing surface is appropriate.

3.2. Core stability

The term Core Stability is known among physiotherapists and physicists, its definition
depending on the area in which it is being discussed.
From a biomechanical point of view, Core stability represents an osteo -ligament
complex that exists below a potential threshold that creates osteo -articular stability. From the
point of view of a physic al therapist, this expression represents a certain degree of resistance
or force encountered in certain muscle groups.
A more narrow
cutting technique
(preferred). A wide cutting
technique (higher
ACL injury risk).

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The aim of the Core Stability training is to efficiently recruit muscles of different body
segments so that subjects can easily learn to control the position of various body segments
during dynamic activity. This type of training can be used to prevent injuries as well as to
recover from injuries to the ankle, knee, shoulder, elbow, and lumbar sacral joints. The
training is based on movemen ts made on unstable surfaces like swiss ball or balance fitt.
(Fig. 13 )

3.3. ACL prevention
The gender difference is apparent when analysing ACL injury risk in handball.
However, the reasons for the obvious gender gap in the risk of ACL injury are not completely
clear. Various researchers have suggested differences in anatomy, hormona l and
neuromuscular function as potential reasons for the higher injury risk in women than in men.
A key external risk identified is high friction between shoes and the playing surface.
Handball is played on different floor types with varying friction characteristics and shock
absorbing ability. Floors are usually of two types: parquet (wooden floor) or artificial floors.
One study has shown that the risk of ACL injury is 2.4× greater when competing on artificial
floors (with an increased coefficient of friction) compared with wooden floors. Therefore, it
seems reasonable to suggest that players should have at least two different pairs of shoes,
one more ‘slippery’ pair suitable for high -friction floors and one pair with more traction for
slippery floors.

Fig. 14 – Balance/co -ordination exercises
Grethe Myklebust says that exercise programmes need to include a combination of
balance/ co-ordination, strength, plyometric and technique exercises (Fig. 14) . These
exercises should therefore be included in the warm -up routine.
Fig. 13 – Exercises with swiss ball

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Conclusion

In conclusion , handball is a high -intensity sport with frequent physical contact between
players . It is as beautiful as dangerous. You can see the same player dancing at the end of
the game today, leaving the field in tears before the end tomorrow.
The handball game can be really spectacular, especially when played at a high level.
The game allows a lot o f tricks which make the public enjoy the show. The evolution of
handball made the palyers stronger and faster, and this came with a risk.
Handball injuries are quite common, and mostly acute injuries occur in the lower
extremities, such as ankle and knee s prains. The most common overuse injuries are in the
shoulder, knee and lower leg. But as you only live once, prevention is the best option.

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References

1. BIRO, Francisc, Handbal de performanță, Editura Universității din Oradea, 2005;
2. CERCEL, Paul, Calități le motrice din handbal, Editura Sport -Turism, 1975;
3. EPURAN, Mihai, Asistență, consiliere și intervenții psihomedicale în sport și
kinetoterapie, Editura Fundației HUMANITAS, 2006;
4. HOFFMAN, Shirl, Introduction to Kinesiology: Studying Phisycal Activity, 2013,
University of North Caroline at Greensboro, Editor Human Kinetics;
5. HANTĂU, Cezar, Accidentările în jocul de handbal, 2011;
6. HOLDHAUS, Hans, Summary of the injury study conducted at the Women’s
Handball EHF EURO 2008;
7. MYKLEBUST, Grethe, Between Basketb all and Rugby: The risk of injury in handball;
8. MYLKEBUST, Grethe, ACL prevention in female handball;
9. ENGEBRETSEN, Lars, MYKLEBUST, Grethe, Exercises to prevent lower limb
injuries in youth sports: cluster randomised controlled trial, 2005.