Shoulder Strengthening Injury Prevention Program for Collegiate Quarterbacks: A Critically Appraised Paper

Authors' Names

Tiffany Heeren

Presentation Type

Poster Presentation

Abstract/Artist Statement

Context: Shoulder injuries have a high prevalence in quarterbacks. These injuries typically occur due to the lack of strength of glenohumeral and scapulothoracic stabilization structures. Previous research focuses on post-injury rehabilitation protocols for shoulder injuries. However, there is limited literature identifying specific strengthening exercises tailored to injury prevention. The purpose of this systematic review is to determine the most effective targeted shoulder strengthening exercises for collegiate quarterbacks established for reducing the incidence of injury.

Methods: PubMed was searched through November 17, 2018 for studies reporting electromyography (EMG) data or injury specific shoulder rehabilitation protocols for overhead athletes. Key words searched were athlete shoulder injury, overhead athlete rehabilitation shoulder, shoulder biomechanics, overhead athlete, and football quarterback. Inclusion criteria included articles with full-text availability in English, published in the last 10 years, and a level of evidence greater than 5. One author screened the results and extracted data for use in this systematic review.

Results: Ten studies with 1649 total patients were included in the review. Four of the 10 studies included were systematic reviews of literature specific to rehabilitation exercises for labrum, rotator cuff, SLAP lesions, and impingement syndrome injuries. Three studies recorded and evaluated the EMG data of % maximal voluntary isometric contractions (%MVIC) in glenohumeral and scapulothoracic musculature during specific shoulder exercises. Three studies of original research examined shoulder rehabilitation exercises for impingement symptoms and SLAP tears. Five strengthening exercises were determined to be ideal in a shoulder strengthening prevention protocol due to highest %MVIC and amount of clinical usage seen in rehabilitation protocols. The exercises included prone shoulder extension, prone shoulder horizontal abduction with external rotation, prone shoulder horizontal abduction at 90 degrees, prone shoulder row with external rotation and side-lying shoulder external rotation.

Conclusion: Shoulder injuries have a higher occurrence rate due to the lack of strength within the stabilizing musculature of the shoulder complex. The vulnerable shoulder positions that quarterbacks use in throwing also increase the rate of injury. Quarterbacks put high, repetitive stresses on their shoulder, requiring unique motions and strength. Strengthening the glenohumeral and scapulothoracic musculature could lead to less prevalence of certain injuries in quarterbacks. Using exercises that focus on both musculature could lead to a decrease quarterback shoulder injuries. The five exercises included have EMG data indicating activation in both glenohumeral and scapulothoracic musculature, as well as literature review of effectiveness in post-injury research.

Mentor Name

Valerie Moody

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Feb 22nd, 5:00 PM Feb 22nd, 6:00 PM

Shoulder Strengthening Injury Prevention Program for Collegiate Quarterbacks: A Critically Appraised Paper

UC North Ballroom

Context: Shoulder injuries have a high prevalence in quarterbacks. These injuries typically occur due to the lack of strength of glenohumeral and scapulothoracic stabilization structures. Previous research focuses on post-injury rehabilitation protocols for shoulder injuries. However, there is limited literature identifying specific strengthening exercises tailored to injury prevention. The purpose of this systematic review is to determine the most effective targeted shoulder strengthening exercises for collegiate quarterbacks established for reducing the incidence of injury.

Methods: PubMed was searched through November 17, 2018 for studies reporting electromyography (EMG) data or injury specific shoulder rehabilitation protocols for overhead athletes. Key words searched were athlete shoulder injury, overhead athlete rehabilitation shoulder, shoulder biomechanics, overhead athlete, and football quarterback. Inclusion criteria included articles with full-text availability in English, published in the last 10 years, and a level of evidence greater than 5. One author screened the results and extracted data for use in this systematic review.

Results: Ten studies with 1649 total patients were included in the review. Four of the 10 studies included were systematic reviews of literature specific to rehabilitation exercises for labrum, rotator cuff, SLAP lesions, and impingement syndrome injuries. Three studies recorded and evaluated the EMG data of % maximal voluntary isometric contractions (%MVIC) in glenohumeral and scapulothoracic musculature during specific shoulder exercises. Three studies of original research examined shoulder rehabilitation exercises for impingement symptoms and SLAP tears. Five strengthening exercises were determined to be ideal in a shoulder strengthening prevention protocol due to highest %MVIC and amount of clinical usage seen in rehabilitation protocols. The exercises included prone shoulder extension, prone shoulder horizontal abduction with external rotation, prone shoulder horizontal abduction at 90 degrees, prone shoulder row with external rotation and side-lying shoulder external rotation.

Conclusion: Shoulder injuries have a higher occurrence rate due to the lack of strength within the stabilizing musculature of the shoulder complex. The vulnerable shoulder positions that quarterbacks use in throwing also increase the rate of injury. Quarterbacks put high, repetitive stresses on their shoulder, requiring unique motions and strength. Strengthening the glenohumeral and scapulothoracic musculature could lead to less prevalence of certain injuries in quarterbacks. Using exercises that focus on both musculature could lead to a decrease quarterback shoulder injuries. The five exercises included have EMG data indicating activation in both glenohumeral and scapulothoracic musculature, as well as literature review of effectiveness in post-injury research.