Table 2

Prevention of shoulder injuries: effect and grading the quality of evidence

OutcomesEffect size
Effect (95% CI)LargeModerateSmall
Risk of shoulder injuries
 Oslo Sports Trauma Research Centre Shoulder Injury Prevention programme versus usual care; n=660, male/female handball1 All shoulder injuries OR=0.72 (0.52 to 0.98)Moderate quality of evidence
Substantial shoulder injuries
OR=0.78 (0.53 to 1.16)
Moderate quality of evidence
Risk of shoulder injury
 Throwing injury prevention programme versus usual care; n=237, male/female baseball43 HR=0.48 (0.21 to 1.08)Moderate quality of evidence
 The Shoulder Control programme versus usual care; n=465, male/female handball47 HRR=0.44 (0.29 to 0.68)Moderate quality of evidence
 FIFA 11+ shoulder prevention programme versus usual care; n=726, male football44 IRR=0.28 (0.13 to 0.60)Moderate quality of evidence
 Intervention including Sleeper’s stretch versus usual care; n=46, male baseball50 HR=0.35 (0.13 to 0.94)Very low quality of evidence
 Intervention including Sleeper’s stretch and prone shoulder external rotation exercise versus usual care; n=60, male baseball50 HR=0.47 (0.20 to 1.10)Very low quality of evidence
 TennisReady programme, versus usual care; n=579, male/female tennis49 OR=0.96 (p=0.93)Low quality of evidence
 Intervention including stretching and rubber band strengthening exercises versus usual care; n=579, male/female handball48 Absolute risk reduction=−2.5%(−10.3 to 5.4)Low quality of evidence
No of shoulder pain episodes
 Intervention including functional exercises using resistance bands or dumbbells versus usual care; n=26, male/female swimming45 Between-group difference in no of shoulder pain episodes=2.8 (CI not reported), p=0.02Low quality of evidence
Patient-reported shoulder pain
 Intervention including shoulder strengthening exercises versus usual care, n=106, female handball46 Between group difference in VAS=0.1 (CI not reported), p=0.746Moderate quality of evidence
  • HR, hazard ratio; HRR, hazard rate ratio; IRR, incidence rate ratio; VAS, Visual Analogue Scale.