The Young Handball Player

  • Leonard Achenbach


Engaging in team handball at a young age has important physical health benefits but also involves risk of injury. Youth handball players may be particularly vulnerable to injury due to growth-related factors such as the growth spurt, susceptibility of the growth plate, and differing physiological response after training and match load. The more frequent and intensive training and competition of young elite handball players may create conditions under which these potential risks can more readily exert their influence. The purpose of this chapter is to provide a current overview of risks related to physical and psychological injury that may be encountered by youth handball players, especially in the elite youth setting.


  1. 1.
  2. 2.
    Micheli LJ. Overuse injuries in children’s sports: the growth factor. Orthop Clin North Am. 1983;14(2):337–60.Google Scholar
  3. 3.
    Schorer J, Cobley S, Büsch D, Bräutigam H, Baker J. Influences of competition level, gender, player nationality, career stage and playing position on relative age effects. Scand J Med Sci Sports. 2009;19(5):720–30.CrossRefGoogle Scholar
  4. 4.
    Figueiredo AJ, Goncalves CE, Coelho ESMJ, Malina RM. Characteristics of youth soccer players who drop out, persist or move up. J Sports Sci. 2009;27(9):883–91.CrossRefGoogle Scholar
  5. 5.
    Helsen WF, Baker J, Michiels S, Schorer J, van Winckel J, Williams MA. The relative age effect in European professional soccer: did ten years of research make any difference? J Sport Sci. 2012;30(15):1665–71.CrossRefGoogle Scholar
  6. 6.
    Johnson A, Farooq A, Whiteley R. Skeletal maturation status is more strongly associated with academy selection than birth quarter. Science and Medicine in Football. 2017;1(2):157–63.CrossRefGoogle Scholar
  7. 7.
    Müller L, Müller E, Hildebrandt C, Kapelari K, Raschner C. Die Erhebung des biologischen Entwicklungsstandes für die Talentselektion—welche Methode eignet sich? Sportverletz Sportschaden. 2015;29(1):56–63.CrossRefGoogle Scholar
  8. 8.
    Stracciolini A, Friedman HL, Casciano R, Howeel D, Sugimoto D, Micheli LJ. The relative age effect on youth sports injuries. Med Sci Sports Exerc. 2016;48(6):1068–74.CrossRefGoogle Scholar
  9. 9.
    Jayanthi NA, LaBella CR, Fischer D, Pasulka J, Dugas LR. Sports specialized intensive training and the risk of injury in young athletes: a clinical case-control study. Am J Sports Med. 43(4):794–801.Google Scholar
  10. 10.
    Newell A, Rosenbloom PS. Mechanisms of skill acquisition and the law of practice. In: Anderson JR, editor. Cognitive skills and their acquisition. Hillsdale, NJ: Erlbaum; 1981. p. 1–55.Google Scholar
  11. 11.
    Simon HA, Chase WG. Skill in chess. Am Sci. 1973;61:394–403.Google Scholar
  12. 12.
    Baker J, Cobley S, Fraser-Thomas J. What do we know about early sport specialization? Not much. High Abil Stud. 2009;20(1):77–89.CrossRefGoogle Scholar
  13. 13.
    Ericsson KA, Charness N. Expert performance: its structure and acquisition. Am Psychol. 1994;49(8):725–47.CrossRefGoogle Scholar
  14. 14.
    Wiersma LD. Risks and benefits of youth sport specialization: perspectives and recommendations. Pediatr Exerc Sci. 2000;12(1):13–22.CrossRefGoogle Scholar
  15. 15.
    DiFiori JP, Benjamin HJ, Brenner JS, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Br J Sports Med. 2013;48(4):287–8.CrossRefGoogle Scholar
  16. 16.
    Brewer BW, Van Raalte JL, Linder DE. Athletic identity: Hercules’ muscle or Achilles heel? Int J Sport Psychol. 1993;24(2):237–54.Google Scholar
  17. 17.
    Ryba TV, Aunola K, Kalaja S, Selanne H, Ronkainen NJ, Nurmi JE. A new perspective on adolescent athletes’ transition into upper secondary school: a longitudinal mixed methods study protocol. Cogent Psychol. 2016;3(1):1–15.CrossRefGoogle Scholar
  18. 18.
    Verkooijen KT, van Hove P, Dik G. Athletic identity and well-being among young talented athletes who live in a Dutch elite sport center. J Appl Sport Psychol. 2012;24(1):106–13.CrossRefGoogle Scholar
  19. 19.
    Pieper HG. Humeral torsion in the throwing arm of handball players. Am J Sports Med. 1998;26(2):247–53.PubMedCentralCrossRefGoogle Scholar
  20. 20.
    Mayr HO, Zaffagnini S. Prevention of injuries and overuse in sports. Directory for Physicians, Physiotherapists, Sport Scientists and Coaches. Heidelberg: Springer; 2016.Google Scholar
  21. 21.
    Andersson SH, Bahr R, Clarsen B, Myklebust G. Risk factors for overuse shoulder injuries in a mixed-sex cohort of 329 elite handball players: previous findings could not be confirmed. Br J Sports Med. 2017.
  22. 22.
    Clarsen B, Bahr R, Andersson SH, Munk R, Myklebust G. Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study. Br J Sports Med. 2014;48(17):1327–33.PubMedCentralCrossRefGoogle Scholar
  23. 23.
    Kristiansen E, Stensrud T. Young female handball players and sport specialisation: how do they cope with the transition from primary school into a secondary sport school? Br J Sports Med. 2017;51(1):58–63.CrossRefGoogle Scholar
  24. 24.
    Booth FW, Thomason DB. Molecular and cellular adaptation of muscle in response to exercise: perspectives of various models. Physiological Review. 1991;71(2):541–85.CrossRefGoogle Scholar
  25. 25.
    Viru A, Viru M. Nature of training effects. In: Garrett W, Kirkendall D, editors. Exercise and sport science. Philadelphia, PA: Lippincott Williams & Williams; 2000. p. 67–95.Google Scholar
  26. 26.
    Gunnarsson TP, Bendiksen M, Bischoff R, Christensen PM, Lesivig B, Madsen K, Stephens F, Greenhaff P, Krustrup P, Bangsbo J. Effect of whey protein- and carbohydrate-enriched diet on glycogen resynthesis during the first 48 h after a soccer game. Scand J Med Sci Sports. 2013;23(4):508–15.CrossRefGoogle Scholar
  27. 27.
    Ispirlidis I, Fatouros IG, Jamurtas AZ, et al. Time course of changes in inflammatory and performance responses following a soccer game. Clin J Sports Med. 2008;18(5):428–31.CrossRefGoogle Scholar
  28. 28.
    Krustrup P, Ortenblad N, Nielsen J, Nybo L, Gunnarsson TP, Iaia FM, Madsen K, Stephens F, Greenhaff P, Bangsbo J. Maximal voluntary contraction force, SR function and glycogen resynthesis during the first 72 h after a high-level competitive soccer game. Eur J Appl Physiol. 2011;111(12):2987–95.CrossRefGoogle Scholar
  29. 29.
    Mohr M, Draganidis D, Chatzinikolaou A, et al. Muscle damage, inflammatory, immune and performance responses to three football games in 1 week in competitive male players. Eur J Appl Physiol. 2016;116(1):179–93.CrossRefGoogle Scholar
  30. 30.
    Nedelec M, McCall A, Carling C, Legall F, Berthoin S, Dupont G. Recovery in soccer: part I—post-match fatigue and time course of recovery. Sports Med. 2012;42(12):997–1015.Google Scholar
  31. 31.
    Tsubakihara T, Umeda T, Takahashi I, Matsuzaka M, Iwane K, Tanaka M, Matsuda M, Oyamada K, Aruga R, Nakaji S. Effects of soccer matches on neutrophil and lymphocyte functions in female university soccer players. Luminescence. 2013;28(2):129–35.CrossRefGoogle Scholar
  32. 32.
    Akova B, Surmen-Gur E, Gur H, Dirican M, Sarandol E, Kucukoqlu S. Exercise-induced oxidative stress and muscle performance in healthy women: role of vitamin E supplementation and endogenous oestradiol. Eur J Appl Physiol. 2001;84(1–2):141–7.CrossRefGoogle Scholar
  33. 33.
    Wathen D, Baechle TR, Earle RW. Training variation: periodization. In: Baechle TR, Earle RW, editors. Essentials of strength training & conditioning. Champaign, IL: Human Kinetics; 2000. p. 513–27.Google Scholar
  34. 34.
    Chiu LZ, Barnes JL. The fitness-fatigue model revisited: implications for planning short-and long-term training. Strength Cond J. 2003;25(6):42–51.Google Scholar
  35. 35.
    Fatouros IG, Chatzinikolaou A, Douroudos II Nikolaidis MG, Kyparos A, Michailidis Y, Vantarakis A, Taxildaris K, Katrabasas I, Mandaladis D, Kouretas D, Jamurtas AZ. Time-course of changes in oxidative stress and antioxidant status responses following a soccer game. J Strength Cond Res. 2010;24(12):3278–86.CrossRefGoogle Scholar
  36. 36.
    Dupont G, Nedelec M, McCall A, McCormack D, Berthoin S, Wisloff U. Effect of 2 soccer matches in a week on physical performance and injury rate. Am J Sports Med. 2010;38(9):1752–8.CrossRefGoogle Scholar
  37. 37.
    Ekstand J, Walden M, Hagglund M. A congested football calendar and the wellbeing of players: correlation between match exposure of European footballers before the World Cup 2002 and their injuries and performances during that World cup. Br J Sports Med. 2004;38(4):493–7.CrossRefGoogle Scholar
  38. 38.
    Brink MS, Visscher C, Arends S, Zwerver J, Post WJ, Lemmink KA. Monitoring stress and recovery: new insights for the prevention of injuries and illnesses in elite youth soccer players. Br J Sports Med. 2010;44(11):809–15.CrossRefGoogle Scholar
  39. 39.
    Cross MJ, Williams S, Trewartha G, Kemp SP, Stokes KA. The influence of in-season training loads on injury risk in Professional Rugby Union. Int J Sports Physiol Perform. 2016;11(3):350–5.CrossRefGoogle Scholar
  40. 40.
    Gabbett TJ, Whyte DG, Hartwig TB, Wescombe H, Naughton GA. The relationship between workloads, physical performance, injury and illness in adolescent male football players. Sports Med. 2014;44(7):989–1003.CrossRefGoogle Scholar
  41. 41.
    Gabbett TJ. The development and application of an injury prediction model for noncontact, soft-tissue injuries in elite collision sport athletes. J Strength Cond Res. 2010;24(10):2593–603.CrossRefGoogle Scholar
  42. 42.
    Hulin BT, Gabbett TJ, Lawson DW, Caputi P, Sampson JA. The acute:chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. Br J Sports Med. 2016;50(4):231–6.CrossRefGoogle Scholar
  43. 43.
    Blanch P, Gabbett TJ. Has the athlete trained enough to return to play safely? The acute:chronic workload ratio permits clinicians to quantify a player's risk of subsequent injury. Br J Sports Med. 2015;50(8):471–5.CrossRefGoogle Scholar
  44. 44.
    Moller M, Nielsen RO, Atterman J, Wedderkopp N, Lind M, Sorensen H, Myklebust G. Handball load and shoulder injury rate: a 31-week cohort study of 679 elite youth handball players. Br J Sports Med. 2017;51(4):231–7.PubMedCentralCrossRefGoogle Scholar
  45. 45.
    Söderman K, Pietilä T, Alfredson H, Werner S. Anterior cruciate ligament injuries in young female playing soccer at senior levels. Scand J Med Sci Sports. 2002;12(2):65–8.CrossRefGoogle Scholar
  46. 46.
    Achenbach L, Krutsch V, Weber J, Nerlich M, Luig P, Loose O, Angele P, Krutsch W. Neuromuscular exercises prevent severe knee injury in adolescent team handball players. Knee Surg Sports Traumatol Arthrosc. 2017.
  47. 47.
    Moller M, Attermann J, Myklebust G, Wedderkopp N. Injury risk in Danish youth and senior elite handball using a new SMS text messages approach. Br J Sports Med. 2012;46(7):531–7.CrossRefGoogle Scholar
  48. 48.
    Nielsen AB, Yde J. An epidemiologic and traumatologic study of injuries in handball. Int J Sports Med. 1988;9(5):341–4.PubMedCentralCrossRefGoogle Scholar
  49. 49.
    Bjordal JM, Arnøy F, Hannestad B, Strand T. Epidemiology of anterior cruciate ligament injuries in soccer. Am J Sports Med. 1997;25(3):341–5.CrossRefGoogle Scholar
  50. 50.
    Walden M, Hägglund M, Werner J, Ekstrand J. The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from a gender-related perspective. Knee Surg Sports Traumatol Arthrosc. 2011;19(1):3–10.CrossRefGoogle Scholar
  51. 51.
    Tak I, Weir A, Langhout R, Waarsing JH, Stubbe J, Kerkhoffs G, Agricola R. The relationship between the frequency of football practice during skeletal growth and the presence of a cam deformity in adult elite football players. Br J Sports Med. 2015;49(9):630–4.CrossRefGoogle Scholar
  52. 52.
    Whittaker JL, Woodhouse LJ, Nettel-Aguirre A, Emery CA. Outcomes associated with early post-traumatic osteoarthritis and other negative health consequences 3–10 years following knee joint injury in youth sport. Osteoarthritis Cartilage. 2015;23(7):1122–9.Google Scholar
  53. 53.
    Ajuied A, Wong F, Smith C, Norris M, Earnshaw P, Back D, Davies A. Anterior ligament injury and radiologic progression of knee osteoarthritis: a systematic review and meta analysis. Am J Sports Med. 2014;42(9):2242–52.CrossRefGoogle Scholar
  54. 54.
    Richmond SA, Fukuchi RK, Ezzat A, Schneider K, Schneider G, Emery CA. Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors of osteoarthritis? A systematic review. J Orthop Sports Phys Ther. 2013;43(8):515–9.CrossRefGoogle Scholar
  55. 55.
    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(2):71–8.CrossRefGoogle Scholar
  56. 56.
    Olsen O, Myklebust G, Engebretsen L, Holme I, Bahr R. Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial. BMJ. 2005;330(7489):449.PubMedCentralCrossRefGoogle Scholar
  57. 57.
    Hoffmann M, Payne VG. The effects of proprioceptive ankle disc training on healthy subjects. J Orthop Sports Phys Ther. 1995;21(2):90–3.CrossRefGoogle Scholar
  58. 58.
    Wedderkopp N, Kaltoft M, Lundgaard B, Rosendahl M, Froberg K. Prevention of injuries in young female players in European team handball. A prospective intervention study. Scand J Med Sci Sports. 1999;9(1):41–7.CrossRefGoogle Scholar
  59. 59.
    Soligard T, Nilstad A, Steffen K, Myklebust G, Holme I, Dvorak J, Bahr R, Andersen TE. Compliance with a comprehensive warm-up programme to prevent injuries in youth football. Br J Sports Med. 2010;44(11):787–93.CrossRefGoogle Scholar
  60. 60.
    Myer GD, Sugimoto D, Thomas S, Hewett TE. The influence of age on the effectiveness of neuromuscular training to reduce anterior cruciate ligament injury in female athletes. Am J Sports Med. 2013;41(1):203–15.CrossRefGoogle Scholar
  61. 61.
    Fabricant PD, Lakomkin N, Sugimoto D, Tepolt FA, Sracciolini A, Kocher MS. Youth sports specialization and musculoskeletal injury: a systematic review of the literature. Phys Sportsmed. 2016;44(3):257–62.CrossRefGoogle Scholar
  62. 62.
    LaPrade RF, Agel J, Baker J, Brenner JS, Cordasco FA, Côté J, Engebretsen L, Feeley BT, Gould D, Hainline B, Hewett TE, Jayanthi N, Kocher MS, Myer GD, Nissen CW, Philippon MJ, Provencher MT. AOSSM early sport specialization consensus statement. Orthop J Sports Med. 2016;4(4):2325967116644241.PubMedCentralCrossRefGoogle Scholar
  63. 63.
    Krutsch W, Voss A, Gerling S, Grechenig S, Nerlich M, Angele P. First aid on field management in youth football. Arch Orthop Trauma Surg. 2014;134(9):1301–9.CrossRefGoogle Scholar
  64. 64.
    Finch C. A new framework for research leading to sports injury prevention. J Sci Med Sport. 2006;9(1–2):3–9.CrossRefGoogle Scholar
  65. 65.
    Russel M, Sparkes W, Northeast J, Cook CJ, Bracken RM, Kilduff LP. Relationships between match activities and peak power output and Creatine Kinase responses to professional reserve team soccer match-play. Hum Mov Sci. 2016;45:96–101.CrossRefGoogle Scholar

Copyright information

© ESSKA 2018

Authors and Affiliations

  • Leonard Achenbach
    • 1
  1. 1.Department of Trauma SurgeryUniversity Medical Centre RegensburgRegensburgGermany

Personalised recommendations