Saudi Journal of Sports Medicine

: 2019  |  Volume : 19  |  Issue : 3  |  Page : 69--71

Injuries in central forward players in handball – Biomechanical perspective

Ahmed Ibrahaim Alomar 
 Department of Physical Therapy, Security Forces Hospital, Dammam, Kingdom of Saudi Arabia

Correspondence Address:
Mr. Ahmed Ibrahaim Alomar
Department of Physical Therapy, Security Forces Hospital, Dammam
Kingdom of Saudi Arabia


Handball is a highly dynamic sport that involves almost all joints during play. Handball, like other dynamic sports, sees common musculoskeletal injuries in various body locations. Identifying the mechanism of injury is the key in injury prevention. This literature review focuses on the biomechanical aspect of injuries in central forward players in handball. This review will assist the coaches and trainers to implement effective training and injury prevention programs among handball players.

How to cite this article:
Alomar AI. Injuries in central forward players in handball – Biomechanical perspective.Saudi J Sports Med 2019;19:69-71

How to cite this URL:
Alomar AI. Injuries in central forward players in handball – Biomechanical perspective. Saudi J Sports Med [serial online] 2019 [cited 2020 Sep 18 ];19:69-71
Available from:

Full Text



Handball is a sport that depends on the player movement, speed, and flexibility. This might lead to injury due to the focus being on moving at high speed while usually, the player will ignore the necessity to move using the correct techniques. This is the main cause of handball injuries.[1] Handball, basketball, and football have common injuries, as all of these sports shares the characteristic of running and trying to out maneuver at high speed. Moreover, a handball team contains six players and a goalkeeper. Player's setup at the field usually is such as left-back, center back, right back, left-wing, right-wing, and center forwarder. However, even with this setup players will certainly move all around the field to cover all the gaps might appear during the game. In this situation, the player should know how to protect himself incorrect position during the attack and can change his status ones he has the ball at the fastest and most accurate way. Shoulders and knees are the joints most affected by overuse in handball.[2] Ankle injury is one of the most common injuries reported among handball players.[2],[3] A major role of the medical team in any sport is player performance analysis to find mistakes and try to advise the player to correct them to avoid re-injury. This will assist the players to decrease the number of injuries during the games. Other psychological and physiological factors affect the rate of injuries.

 Profile of the Position

The center forwarder position at the center of the felid between two wings. The center forwarder tries to slip between the opposing defenses and create an opening. At this situation, high chance of traumatic injuries might happen due to the clashes will take place for each player to have the ball. Besides, players can make a lot of technical mistakes in the game during the attack. Furthermore, there are specific skills and techniques that center forwarder need to be a part of his movement at the game but, in most cases, the center forwarder uses a bad technique that can lead to injury. The most important features that a center forwarder needs are a good physical body condition. This will allow him to handle the opposition defender hard. Speed is an important feature for handball players in general because this sport depends on immediate change from defense to attack. High jumping and shooting are also needed to score goals. These are the most important skills needed by a center forwarder in handball to facilitate his role on felid.

 Rotation Movement

One of the special skills for a center forwarder is rotation. This movement is required when the defenders and the goalkeeper of the opposing team are at his back and waiting for him to pass the ball from other teammates. When the player has the ball he needs to rotate to face the goalkeeper and shoot at the same time. In this case, a serious injury can happen because of focusing on shooting to score and ignoring the proper way to rotate.

Loading the whole body weight on one leg and rotating through 180 degrees puts a player at high risk of injury.[4] The most common mistake in this movement occurs when the player fixes his one leg on the ground and tries to rotate from the upper body. In this case, the leg will be fixed in the ground and subject to rotation force. There will then be a high incidence of anterior cruciate ligament (ACL) and meniscus injuries due to the mechanism of this movement.[4] In terms of this skill, the focus should be on a smooth sequence. There is a need to start the movement from the upper bodyside, followed by the leg being moved next to avoid knee injury or stress. Besides, the type of shoes is playing a very important matter in this case. By choosing correct shoes can be helpful to facilitate the movement and deviate the force among the foot.[5] On the other hand, incorrect shoes can restrict movement and adding more stress which might cause injury due to the player implanting his leg on the ground. Avoiding using the right techniques may harm the players. The center forwarder needs it to score goals or even to assist a teammate. Choosing proper shoes and training to master this skill with the correct technique are ways of avoiding injury.


Shooting using the hand means that most loading will be on the shoulder joint and muscles. The shoulder joint depends on muscle to stabilize the joint. Consequently, muscle jet fatigue or injured shoulder stability will directly affect and may even worsen the injury. For the reasons given above, we should always focus on moving correctly to save the player's shoulder.

One of the main roles of the center forwarder in handball is scoring; therefore, he will take an extra load on the shoulder joint compared with other players. In taking penalties, the player needs to focus on his target and keep at least on leg stable on the ground. Shooting without any forward or side movement to save his joint from any trauma can be lead to injury.

The second mistake made by players when shooting frequently happens when all the players of the opposing team defend. At this time, the player needs to create even a small opening between opposing players to score a goal. In such a situation, the defending players of the opposing team make strong tackles. When the center forwarder sees all these defenders in front of him, he will try to jump between the opposing players and shoots during the jump. Thus, in light of the previous situation, the center forwarder will be at high risk of losing balance, and this may lead to injury. In this case, the main problem is how the player jumps and tries to move on an opposing defender using the upper part of his body and shooting at the same time. This position puts the player at high risk of injury due to the high stress caused by this movement.[6] If the opponent tackles as he shoots this can lead to a shoulder injury as well.[7] In addition, if the player loses his balance and falls on his knee, this may lead to knee injury. Players should be introduced to the right technique to use and must do it during a match or even during training sessions, even during the hardest situation, players should always look to find the safest and best way to do the job and avoid injuries as well.


One of the most important movements in several sports is landing techniques. Players always want to jump higher than the others, but forget the importance of landing correctly. What typically happens with a center forwarder is that he jumps correctly when shooting or passing the ball, but frequently lands incorrectly. He always landing with valgus positions in a single leg. This is very serious due to harmful may lead from this position. The reason for this is the enthusiasm and pressure shown during the game. Landing inappropriately can lead to an ankle sprain, mostly due to the twisting of the ankle.[8],[9] In addition, an inferior landing can lead to a fracture of the ankle because of ankle cannot tolerate undue bodyweight.[10] Furthermore, a loss of balance can occur when the player is jumping between opposition defenders. This makes the center forwarder who plays up front more vulnerable to these injuries than others. Dealing with a strong defender and focus incorrect position is something hard but necessary. In addition, injuries may occur as a result of overuse, due to repeatedly jumping and landing during a match or in training.[11] This mostly led to ruptures or inflammations of the ankle ligament, such as the Achilles tendon. Sometimes, it may even cause a stress fracture.[10] Furthermore, in the case of acting in defense, the center forwarder mostly will come back and try to help his teammates by blocking an opponent's shot by jumping. Landing with valgus rotation can lead to many injuries, one of which is cutting the ACL in a finding that may come from an opponent, or even stepping on an opponent while landing.[12] Injury to the knee valgus or tibia abduction relative to the femur during the performance of sports has been reported as a risk of injury to the ACL.[12] In addition, landing incorrectly may cause meniscal injuries, either complete or partial rupture.[13] The fact that the player frequently jumps during training and matches and tournaments places a tremendous amount of pressure on the knee, and with the landing incorrectly, the high incidence of such injuries is to be expected. The issue with previous injuries is that it is very unlikely to prevent the player from jumping or changing his position on the field during the game. To deal with this issue, the player should focus on raising the fitness level of the player, work more on strengthening the muscles, and also not stress the player excessively during training, or even during matches to avoid any injuries. Playing is not allowed when the player is suffering from any injury because this will often increase the condition. Most recent studies have shown the importance of landing correctly, indicating that it is the most important skill that a player should master in handball. It is the only factor among all factors which relates to most injuries, especially in terms of injuries to the lower part of the body.


In many sports, performance analysis will always be good in terms of increasing athletes' performance. Looking for mistakes and trying to find the best way to solve them is what we want to achieve. The analysis of athletes' performance should be done by the medical and technical teams to consider player performance from different points of views. Furthermore, the correction of wrong techniques for athletes will help them to decrease the rate of injury. However, we should always bear in mind the differences between one sport and another. In addition, individual differences between athletes are an important factor that can affect performance. This is because sometimes the problem is one of muscular imbalance or minor injury that can affect an athlete's performance. Preseason examination is a perfect way to analysis an athlete's performance. This examination will provide the technical staff and the medical staff in a club a strong background concerning the athletes before starting competitive games. Hence, fixing a problem before the season starts will help an athlete to enhance his performance and also to avoid injury as much as possible.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


1Giroto N, Hespanhol Junior LC, Gomes MR, Lopes AD. Incidence and risk factors of injuries in Brazilian elite handball players: A prospective cohort study. Scand J Med Sci Sports 2017;27:195-202.
2Rosa BB, Asperti AM, Helito CP, Demange MK, Fernandes TL, Hernandez AJ. Epidemiology of sports injuries on collegiate athletes at a single center. Acta Ortop Bras 2014;22:321-4.
3Nuhmani S, Khan MH. Lateral ankle sprain: A review. Saudi J Sports Med 2014;14:14.
4Arner JW, Irvine JN, Zheng L, Gale T, Thorhauer E, Hankins M, et al. The effects of anterior cruciate ligament deficiency on the meniscus and articular cartilage: A novel dynamicin vitro pilot study. Orthop J Sports Med 2016;4:2325967116639895.
5Knapik JJ, Orr R, Pope R, Grier T. Injuries and footwear (Part 2): Minimalist running shoes. J Spec Oper Med 2016;16:89-96.
6Quadros GA, Döhnert MB. Humeral retroversion and shoulder rotational mobility in young handball practitioners. Acta Ortop Bras 2015;23:299-302.
7Cools AM, Johansson FR, Borms D, Maenhout A. Prevention of shoulder injuries in overhead athletes: A science-based approach. Braz J Phys Ther 2015;19:331-9.
8van der Does HT, Brink MS, Benjaminse A, Visscher C, Lemmink KA. Jump landing characteristics predict lower extremity injuries in indoor team sports. Int J Sports Med 2016;37:251-6.
9Raina S, Nuhmani S. Factors leading to lateral ankle sprain: A review of the literature. J Musculoskeletal Res 2015;17.
10Chen TL, An WW, Chan ZY, Au IP, Zhang ZH, Cheung RT. Immediate effects of modified landing pattern on a probabilistic tibial stress fracture model in runners. Clin Biomech (Bristol, Avon) 2016;33:49-54.
11Doyscher R, Kraus K, Finke B, Scheibel M. Acute and overuse injuries of the shoulder in sports. Orthopade 2014;43:202-8.
12Bassiri Z, Eslami M. The effect of shoe outsole containing nanoilica particles on knee valgus angle in athlete females with anterior cruciate ligament injury during drop jump and single leg landing. Iran J Public Health 2014;43:1466-7.
13Lippross S, Prange G, Oehlert K, Furkmann O, Seekamp A, Hassenpflug J, et al. Mass sports improves proprioception and reduces valgus stress on the female knee joint. Z Orthop Unfall 2010;148:210-4.