Diagnosis, prevention and treatment of common shoulder injuries in sport: grading the evidence – a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF)

Abstract

This statement paper summarises and appraises the evidence on diagnosis, prevention, and treatment of common shoulder injuries in sports. We systematically searched Medline and Embase. The Grading of Recommendations Assessment, Development and Evaluation tool was applied to evaluate the overall quality of evidence.For diagnosis, we included 19 clinical tests from mixed populations. Tests for anterior instability, biceps-labrum complex injuries and full subscapularis rupture had high diagnostic accuracy (low to moderate quality of evidence).For prevention, the Oslo Sports Trauma Research Center, the Shoulder Control, the FIFA 11+ shoulder injury prevention programmes, and a baseball-specific programme (range of motion, stretching, dynamic stability and strengthening exercises) showed moderate to large effect size in reducing the risk of shoulder injury compared with no intervention (very low to moderate quality of evidence).For treatment, a rehabilitation programme including stretching, ice packs, electrotherapy and compression, and strengthening exercises showed a large effect size in reducing pain and disability compared with no intervention in athletes with subacromial impingement syndrome (very low to moderate quality of evidence). For the treatment of supraspinatus tendinopathy, hyperthermia treatment (heating the skin to 38°C–40°C) resulted in large effect size in reducing pain and disability compared with ultrasound or pendular swinging and stretching exercises (moderate quality of evidence). Strengthening exercise alone or in combination with stretching exercises promoted a large effect in reducing shoulder pain (cohort studies, no comparators) (very low quality of evidence). The quality of evidence for most estimates was low to moderate, indicating that future high-quality research may alter our recommendations for clinical practice.

Injuries and Persistent Pain in Elite Adolescent Archery Athletes: A Cross-Sectional Epidemiological Study

“…Notably, participants in our research predominantly focused on upper body strengthening, neglecting core and lower limb conditioning, which are vital for proper alignment and stability during shooting sessions [ 45 , 46 ]. Proper alignment not only enhances performance but also reduces the risk of shoulder injuries [ 46 , 47 , 48 , 49 ], a commonly affected area in archery. Furthermore, our findings highlight the presence of chronic pain symptoms in a significant proportion of young archers, indicating the necessity for a multidisciplinary approach to address both physical and psychosocial aspects of injury prevention and rehabilitation.…”

Rehabilitation of Supraspinatus Impingement in a Volleyball Athlete: A Case Report

“…Athletes should refrain from engaging in activities including weightlifting or sports-specific exercises like throwing that might reproduce symptoms. In the management of supraspinatus tendinopathy, hyperthermia therapy provided a significant benefit amount in reducing pain and disability when in comparison with ultrasound or pendular swinging and stretching procedures (poor degree of evidence) [ 18 ]. Neuromuscular electrical stimulation and isometric training can help alleviate muscle restriction of the RC muscles caused by post-injury discomfort and joint effusion [ 19 ].…”

Shoulder & Elbow

“…Authors from Denmark reviewed and graded evidence for sports-related injuries to produce a statement paper commissioned by the Danish Society of Sports Physical Therapy. 3 The statement group…”

“…Authors from Denmark reviewed and graded evidence for sports-related injuries to produce a statement paper commissioned by the Danish Society of Sports Physical Therapy. 3 The statement group made recommendations in three key areas: diagnostic tests, prevention, and treatment regimes. A systematic search of the MEDLINE and Embase databases was performed and the Grading of Recommendations Assessment, Development and Evaluation tool was used to evaluate the overall quality of evidence.…”