{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T21:08:47Z","timestamp":1773608927201,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,8,26]],"date-time":"2014-08-26T00:00:00Z","timestamp":1409011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,8,26]],"date-time":"2014-08-26T00:00:00Z","timestamp":1409011200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this study was to develop a preventive exercise protocol based on structural and functional changes present in shoulder joints of young throwing athletes. As a proof of concept, these changes were previously evaluated in a cross\u2010section of high\u2010performance junior javelin throwers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirteen members of the German and Bavarian junior javelin squad (mean age 17.5 \u00b1 0.8 years) completed a systematic clinical examination, shoulder range of motion (ROM) measurement, and were scored with standardized clinical tools. 3.0 tesla magnetic resonance imaging (MRI) was conducted on both shoulders. Bilateral three\u2010dimensional analysis of the scapulothoracic motion during multiplanar humeral elevation and isokinetic strength testing of the shoulder internal and external rotators was accomplished. Based on the findings, a preventive exercise protocol was confirmed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Dominant internal ROM was significantly decreased (dominant 48\u00b0 \u00b1 20\u00b0 vs. non\u2010dominant 57\u00b0 \u00b1 19\u00b0; <jats:italic>P<\/jats:italic> = 0.006) and dominant external ROM increased (dominant 117\u00b0 \u00b1 15\u00b0 vs. non\u2010dominant 107\u00b0 \u00b1 10\u00b0; <jats:italic>P<\/jats:italic> = 0.008). MRI revealed posterosuperior intraosseous cysts of the humeral head with a size larger than &gt;3\u00a0mm in 69 % of the dominant shoulders and only in 15 % in the non\u2010dominant shoulders. Motion analysis of the static scapular resting position was significantly different between dominant and non\u2010dominant sides regarding anterior tilt (dominant &gt; non\u2010dominant, mean difference 4.2\u00b0, <jats:italic>P<\/jats:italic> = 0.010) and retraction (dominant &gt; non\u2010dominant, mean difference 2.4\u00b0, <jats:italic>P<\/jats:italic> = 0.038). Dominant scapular anterior tilt during flexion and abduction was significantly increased (\u22124.3\u00b0, <jats:italic>P<\/jats:italic> = 0.006; \u22123.4\u00b0, <jats:italic>P<\/jats:italic> = 0.046). Dominant retraction was significantly increased during abduction (\u22122.3\u00b0, <jats:italic>P<\/jats:italic> = 0.040). Isokinetic outcome parameters presented nonsignificant bilateral differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elite junior javelin throwers already present structural (humeral intraosseous cysts) and biomechanical changes (ROM deficits and asymmetric scapulothoracic motion patterns), even if they have no history of major shoulder pain or injury. A novel exercise protocol was developed in order to address the complex of alterations in a comprehensive way. Preventive diagnostics in combination with a systematic all\u2010year preventive exercise intervention might be one option to detect and control risk factors of a symptomatic throwing shoulder at an early stage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-014-3223-y","type":"journal-article","created":{"date-parts":[[2014,8,24]],"date-time":"2014-08-24T23:52:20Z","timestamp":1408924340000},"page":"1931-1942","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Structural and biomechanical changes in shoulders of junior javelin throwers: a comprehensive evaluation as a proof of concept for a preventive exercise protocol"],"prefix":"10.1002","volume":"24","author":[{"given":"Knut","family":"Beitzel","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Sports Medicine Klinikum rechts der Isar Technische Universit\u00e4t M\u00fcnchen Ismaninger Stra\u00dfe 22 81675 Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia F.","family":"Zandt","sequence":"additional","affiliation":[{"name":"Department of Biomechanics in Sports Faculty of Sport and Health Sciences Technische Universit\u00e4t M\u00fcnchen Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Buchmann","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Sports Medicine Klinikum rechts der Isar Technische Universit\u00e4t M\u00fcnchen Ismaninger Stra\u00dfe 22 81675 Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten I.","family":"Beitzel","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Pediatric Radiology St\u00e4dtisches Klinikum M\u00fcnchen\u2010Schwabing Munich Germany"},{"name":"Department of Radiology Campus Grosshadern University Hospital Munich Ludwig\u2010Maximilians Universit\u20acat Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ansgar","family":"Schwirtz","sequence":"additional","affiliation":[{"name":"Department of Biomechanics in Sports Faculty of Sport and Health Sciences Technische Universit\u00e4t M\u00fcnchen Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas B.","family":"Imhoff","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Sports Medicine Klinikum rechts der Isar Technische Universit\u00e4t M\u00fcnchen Ismaninger Stra\u00dfe 22 81675 Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter U.","family":"Brucker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Sports Medicine Klinikum rechts der Isar Technische Universit\u00e4t M\u00fcnchen Ismaninger Stra\u00dfe 22 81675 Munich 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