Effects of 6-Week Sling-Based Training of the External-Rotator Muscles on the Shoulder Profile in Elite Female High School Handball Players

Context: In women's handball, the large numbers of throws and passes make the shoulder region vulnerable to overuse injuries. Repetitive throwing motions generate imbalance between shoulder internal- and external-rotator muscles. It has not yet been established whether sling-based training can improve shoulder external-rotator muscle strength. Objective: This study investigated the effectiveness of a 6-wk strengthening program in improving shoulder functional profile in elite female high school handball players. Design: Crossover study. Setting: National elite handball training center. Participants: 25 elite female high school handball players. Interventions: The program, completed twice per week for 6 wk, included sling-based strengthening exercises using a suspension trainer for external rotation with scapular retraction and scapular retraction alone. Main Outcomes: Maximal shoulder external- and internal-rotation strength, shoulder external- and internal-rotation range of motion (ROM), and maximal thro...