Prevention of shoulder injuries in overhead sports

Background Shoulder injuries and sports-related shoulder pain represent a significant burden for athletes who participate in overhead sports. The challenges in injury prevention lie in identifying relevant risk factors and implementing viable injury prevention programs. Objectives Determination of relevant risk factors of shoulder injuries and of evidence-based injury prevention programs for overhead athletes. Materials and methods Evaluation and critical review of clinical studies and expert opinions regarding risk factors and injury prevention programs for overhead athletes. Results Most of the potential risk factors have limited evidence and are not modifiable. Among the modifiable risk factors, it was shown that pre-existing glenohumeral internal rotation deficit (GIRD), limited range of motion, imbalance of muscle strength for internal and external rotation to the disadvantage of external rotation, and scapular dyskinesia can increase the risk of chronic shoulder pain due to overuse. Training and competition volume have been found to increase the risk of shoulder injury as fatigue increases. Several prevention programs reduced the incidence of shoulder injuries. For all programs, compliance seems to be of major importance. Conclusion Risk factors for shoulder injuries have been identified and can be assessed in overhead athletes. While many important risk factors are non-modifiable, several others can be addressed by specific prevention programs. Several successful programs have been developed. Compliance and acceptance among overhead athletes are of major importance to reduce the risk of injury.