"Training load and functional performance associated with non-contact upper extremity injuries in overhead athletes: A kinetic chain based prospective cohort study".

OBJECTIVE

To examine the association between preseason kinetic chain-related postural alignment, neuromuscular control and functional performance and non-contact upper extremity injuries in overhead athletes.

DESIGN

Prospective cohort study.

SETTING

Field-based preseason screening with in-season injury surveillance.

PARTICIPANTS

143 overhead athletes from 11 teams.

MAIN OUTCOME MEASURES: Preseason assessments comprised spinal postural alignment, shoulder range of motion, the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), the Single-Leg Squat Test (SLST) and weekly training volume. Non-contact upper extremity injuries were recorded throughout the season.

METHODS

Group comparisons used parametric and non-parametric tests; independent variables were identified with multivariable logistic regression.

RESULTS

Forty-five athletes (31.5%) sustained an upper extremity injury, 73.3% non-contact. Higher weekly training volume (OR 1.20, 95% CI 1.03-1.40), lower CKCUEST performance (OR 0.86, 95% CI 0.76-0.98) and poorer SLST performance (good vs. poor: OR 0.08, 95% CI 0.010-0.622; moderate vs. poor: OR 0.17, 95% CI 0.047-0.596) were independently associated with risk. Sex, shoulder rotational asymmetry and static spinal alignment were not.

CONCLUSIONS

Non-contact upper extremity injuries are linked to modifiable kinetic chain factors. Integrating CKCUEST and SLST with training-load monitoring into preseason screening may improve early risk identification.