Preseason Shoulder Screening Protocol (PSSP) for Collegiate Overhead Athletes

Abstract

PURPOSE: Collegiate athletes who participate in overhead sports have been reported to be at a high risk of shoulder injuries. This study aims to investigate a Preseason Shoulder Screening Protocol (PSSP) created to identify risk of shoulder injury during the season of competition for an athlete. METHODS: A total of 58 division III collegiate overhead athletes from the baseball, softball and swimming teams agreed to participate and signed an approved informed consent. The PSSP included: scapular position at rest and 90° of shoulder abduction (ABD) with and without a load, glenohumeral (GH) internal rotation (IR), external rotation (ER) and horizontal adduction (ADD) range of motion (ROM), GH IR and ER strength, pectoralis minor length, and the closed kinetic chain upper extremity stability test (CKCUEST). The athletes were monitored throughout their season and then at one year using an online survey to report shoulder injuries. DATA ANALYSIS: Descriptive statistics and cross tabulation of history of injury and injury during the one year follow up was performed. Analysis of variance were calculated to determine significant differences among athletes. RESULTS: Athletes from different sports demonstrated significant differences in their performance especially in GH IR ROM, scapular positions @ 90° GH ABD, loaded scapular positions @ 90° GH ABD, pectoralis minor length, IR strength testing, ER strength testing and CKCUEST. Nine athletes (15%) reported shoulder injuries in the one-year following screening and 6 (12%) where injured during the season. Within one-year following the PSSP, 31% of athletes who reported a history of shoulder injury were injured again compared to only 11% of athletes who did not report a history of injury (OD 3.6 and RR = 2.41) CONCLUSIONS: This study found that each sport had a unique performance on the PSSP. These differences may be linked to gender, training regimens and the physical requirements of each sport. This finding may make it challenging to use a single cluster of impairments to predict future injuries across all overhead sports using the PSSP. The current injury rate reported has prohibited calculation of the predictive validity of the PSSP. Future prospective cohort study designs using the PSSP will require a larger number of athletes to have sufficient injuries reported.