Summary

The primary aim of our systematic review was to determine risk factors associated with shoulder injuries in female athletes who play overhead sports. Our secondary aim was to evaluate prevention strategies that reduce injury risk in female overhead athletes.

Abstract

Introduction

Sports involving overhead motion (e.g. volleyball, baseball, softball, handball, tennis, and swimming) put substantial biomechanical demands on the shoulder and, consequently, may result in injuries. Further work examining risk factors and injury prevention programs specifically in female overhead athletes is warranted. The purpose of this study was to systematically review the literature to determine risk factors for shoulder injuries in female athletes who play overhead sports. The secondary aim was to evaluate strategies to reduce the risk of shoulder injuries in female athletes playing overhead sports.

Methods

A systematic review of the literature was performed according to PRISMA guidelines. Several databases including PubMed, Tulane Matas Library Search Engine, and Google Scholar were searched. The following search terms were used: “overhead injuries AND female athletes”. In addition, risk factors pertaining to overhead injuries in female athletes were searched and evaluated.

Results

From the 1574 studies imported for screening, 23 full text articles were extracted based on eligibility and search criteria. Volleyball 6/23 (26%) was the most common sport with overhead injury followed by softball 5/23(22%), swimming 5/23(22%), gymnastics 4/23(17%), tennis 3/23 13%), water polo 2/23 (8%) and basketball 1/23 (4%). There were six risk factors described among the 23 studies. Nine of 23 (39%) studies identified the dominant shoulder as a risk factor for overhead injury (average RR of 2.04), while 6 (26%) studies cited volume of repetition and overuse as a prominent risk factor (RR of 1.45). The amount of time participants spent in the sport was also an important risk factor (RR of 2.92), suggesting that a longer period of time playing a particular sport led to a higher incidence/risk of encountering an overhead injury. Other risk factors included playing at the collegiate vs. high school level (average RR of 2.98) and having had an injury in the past (RR of 1.85) (Table 2).

Conclusion

Dominant shoulder, volume load and overuse, time in sport, and prior injury all are risk factors associated with shoulder injuries in female athletes who play overhead sports. Injury prevention strategies can include creating training programs that are more suitable to prevent development of musculoskeletal injuries, deterring recurrent injury as well as integrating new training programs with kinesiology technology, sport rehabilitation and therapeutic strategies. The ability of these programs to decrease shoulder injuries in female overhead athletes warrants further investigation.