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Br J Sports Med. 2018 Oct;52(20):1312-1319. doi: 10.1136/bjsports-2017-098254. Epub 2018 Mar 26.

Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis.

Author information

1
Musculoskeletal and Sports Injury Epidemiology Center, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
2
Naprapathögskolan-Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden.
3
Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
4
Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
5
Department of Orthopaedics, Hässleholm-Kristianstad-Ystad Hospitals, Hässleholm, Sweden.
6
Football Research Group, Linköping, Sweden.
7
Performance and Training Unit, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden.
#
Contributed equally

Abstract

OBJECTIVE:

To assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports.

DESIGN:

Systematic review with best-evidence synthesis.

DATA SOURCES:

Medline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES:

Randomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria.

RESULTS:

Of 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power.

CONCLUSIONS:

All investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports.

PROSPERO TRIAL REGISTRATION NUMBER:

CRD42015026850.

KEYWORDS:

baseball; cohort study; handball; injury prevention; tennis

PMID:
29581141
DOI:
10.1136/bjsports-2017-098254
[Indexed for MEDLINE]

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