EXERCISE PRESCRIPTION FOR OVERHEAD ATHLETES WITH SHOULDER PATHOLOGY: A SYSTEMATIC REVIEW WITH BEST EVIDENCE SYNTHESIS.

BACKGROUND & OBJECTIVE

According to injury statistics reported by the National Collegiate Athletic Association (NCAA), up to 30% of overhead athletes suffer a shoulder injury during their collegiate athletic career. When looking specifically at swimmers, shoulder injury statistics are as high as 67%. While there are a number of studies demonstrating the effectiveness of conservative management for a variety of shoulder pathologies, the evidence to support specific exercise protocols is uncertain. The primary objective of this systematic review was to consider exercise prescription in regard to treating shoulder pathology in overhead athletes with the goal of illuminating specific exercise approaches.

METHODS

The authors used a PICOS methodology to select and assess the strength of articles for the systematic review. PICOS is an acronym standing for population, intervention, comparison or control, outcome assessment, and study design. Inclusion criteria included studies on an overhead athletic population, the presence of pain or injury, conservative exercise management, a detailed description of the actual exercise intervention, and the presence of an analytical component examining the effectiveness of the intervention.

The authors used 39 studies in this review: 3 prospective cohort, 2 randomized cohort, 1 case series, and 33 expert opinions. Experts were defined as having a board-certified clinical specialty or having at least 5 years of clinical experience treating overhead athletes. Of the 6 research studies used, 3 were on shoulder impingement, and the other 3 on a more generalized diagnosis of shoulder pain or inhibition.

RESULTS

The most common impairments seen with shoulder pathology are deficits in strength and motor control at both the glenohumeral and scapulothoracic joints. It is purported that the repetitive overhead demand of specific sports and activities creates periscapular and rotator cuff

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