Objective To analyze the effectiveness of shoulder injury prevention programs in overhead athletes. Design Systematic Review. Methods CINAHL, Embase, PubMed, and SPORTDiscus electronic databases were searched from database inception through December 2020 for randomized controlled or prospective cohort studies that implemented shoulder injury prevention programs in overhead athletes and reported shoulder injury incidence rates. Results Seven studies fulfilled the inclusion criteria. Two studies reported on odds ratios (OR) that resulted in a reduction of shoulder injuries in overhead athletes following shoulder strengthening and flexibility exercises (OR, 0.72; 95% CI; 0.52, 0.98; OR, 0.22; 95% CI; 0.06, 0.75). One study reported on hazard ratio (HR) that resulted in a reduction of shoulder injuries following stretching of the posterior capsule (HR, 0.36; 95% CI; 0.13, 0.95). Conclusion There is limited research surrounding the effectiveness of shoulder injury prevention programs in overhead athletes specific to injury reduction. Only three studies reported a favorable effect in terms of injury prevention, with only one study at low risk of bias. At present, no conclusions can be made regarding the effectiveness of shoulder injury prevention programs in the overhead athlete. Highlights • Research is lacking regarding the effectiveness of shoulder injury prevention programs and overall injury incidence rate. • The effectiveness of shoulder injury prevention programs is inconclusive due to conflicting results. • Further research is needed to develop international guidelines on best prevention strategies for overhead athletes.
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