Hypermobility and pain in competitive players.

Material The research will be performed among competitive players of Lesser Poland Volleyball and Swimmer League. The participants will e members of both male and female teams. Research material will include about 160 participants, out of which 80 will be males and 80 will be females between 15 and 35 years of age. Method In order to collect data we will use our own questionnaire and three different scales/questionnaire (Beighton, Carter and Wilkinson, Hakim and Graham) to estimate Joint Hypermobility of participants. In order to evaluate collected data we will implement methods of descriptive statistics and statistical analysis. Questionnaire Our anonymous questionnaire will be composed of 25 questions: closed questions, semi open and open questions. First part of questions will pertaine to physical attributes of participants i.e. sex, body height, body weight. Further part of the questionnaire will compose of questions pertaining to career length and number of practices during the season. Remaining ten questions dealt with injuries sustained within last year with particular emphasis on the joint. Last question included VAS scale, which will be used to estimate average intensity of pain of during and after the training.. Hypermobility evaluation After filling up the questionnaire each participant will be evaluate with Beighton scale, Carter and Wilkinson Scale and Hakim and Graham Questionnaire in regards to increased range of motion of the joints. Beighton Scale: All participants will performe five maneuvers including four (concerning lower and upper extremities) symmetrical exercises for which they could get maximum of nine points. In our study in order to diagnose Constitutional Joint Hypermobility the cutt off was > 4/9. To estimate increased range of motion of the joints five following maneuvers was performed. All five maneeuvers are parts of Beighton scale. 1. Hyperextension of the elbow joint >10 degrees. The extension of the elbow joint was measured with goniometer with previous stabilization of the shoulder. The axis of the goniometer was set up on lateral epicondyle. The stable arm of the goniometer was aligned along the long axis of the participant's arm (directed towards greater tubercule of the humerus). The movable arm was aligned along radial bone (directed towards styloid proccess of radial bone) with forearm in supination. 2. Passive thumb – forearm touch. This exercise was performed by participants themselves. Each team member passively flexed the thumb in CMC joint with simultaneous flexion in radio-metacarpal joint in order to touch the forearm with its thumb. 3. Hyperextension in MCP V joint >90. The extension in MCP V joints was measured with goniometer. The goniometer was placed on the ulnar side of the hand. The stable arm of the goniometer was placed along the long axis of the fifth metacarpal bone, whereas the movable arm was placed along the long axis of the proximal phalanx. The axis of rotation of the goniometer was aligned with the axis of rotation of MCP V joint. 4. Hyperextension in the knee joint >10 This angle was also measured with goniometer. The axis of the goniometer was placed in the area of lateral condyle of the femur (superior to head of the fibula). The stable arm of the goniometer was placed along the femur aiming at the greater trochanter. The movable arm was placed along the fibula and was aiming at the lateral malleolus. 5. The ability of placing both hands flat on the floor with knees in extention was assessed. Carter and Wilkinson Scale: All participants will performe five maneuvers including passive opposition of the thumb to the flexor aspect of forearm, passive hyperextension of the fingers so they lie parallel to the extensor aspect of the forearm, hyperextension of the elbow >10º, hyperextension of the knee >10º, increased dorsiflexion of the ankle and inversion of the foot.. Hakim and Graham Questionnaire: All participants will be asked five questions including Can you (or could you ever) place your hands flat on the floor without flexing your knees, Can you (or could you ever) bend your thumb to touch your forearm, As a child, did you amuse your friends by contorting your body into strange shapes or could you do the splits, As a child or teenager, did your kneecap or shoulder dislocate on more than one occasions Do you consider yourself “double jointed”.