The Karolinska Handball Study part II – A randomized controlled trial of injury prevention in adolescent elite handball players

A randomized controlled trial (RCT) to evaluate the effect of two training programs on shoulder and knee injuries.


The incidence and prevalence of knee and shoulder injuries in adolescent handball is high, but very few studies have evaluated the effect of preventative measures for these injuries in this population. This trial builds on the results and knowledge gained from the Karolinska Handball Study part I and is an important next step in the work for reducing shoulder and knee injuries in adolescent handball.


The overall aim with this RCT is to evaluate the effect of two training programs, ”Axelkontroll” and ”Knäkontroll” in adolescent elite handball players.


Over 700 female and male handball players, aged 15–19, were included. At baseline they answered a comprehensive questionnaire and were thereafter randomized to one of three groups. Group 1 was instructed to perform the shoulder training program “Axelkontroll” with focus on shoulder strength and coordination, including an off-season throwing program. Group 2 was instructed to perform the knee training program with focus on strength and coordination of the lower limb. Group 3, the control group, was instructed to carry on as usual. The payers were then monitored by weekly reports for one year regarding match- and training amount, workload and injuries. The primary outcome is shoulder and knee injuries. At study start throwing velocity, shoulder strength, knee control and jumping performance was assessed in a subgroup of approximately 160 players. These measurements was repeated after six months and after one year to evaluate the effect also on performance.


Shoulder and knee injuries are common in adolescent handball and evaluating injury prevention measures is an important step to reduce these injuries.

Research principle

Karolinska Institutet


Swedish Research Council for Sport Science, Scandinavian College of Naprapathic Manual Medicine, Swedish Naprapath Association.


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Eva E. Skillgate

Visiting Professor
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Martin Asker

Affiliated To Research;Affiliated to Research
Content reviewer:
Anna Frantz