A systematic review of shoulder injury prevalence, proportion, rate, type, onset, severity, mechanism and risk factors in female artistic gymnasts

Abstract Objectives Systematically review shoulder injury prevalence, proportion, rate, type, onset, severity, mechanism, risk factors in female artistic gymnasts. Methods PubMed, Web of Science, Scopus, Cochrane Library were searched on 7/01/2017. Original studies reporting data for female artistic gymnasts only, of any age or level were included. Quality assessment was undertaken using Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results Fifteen observational studies were included. Thirteen were poor/fair quality. Shoulder injury prevalence (0%–86.9%) was higher in international (29.2%) versus national (20%) gymnasts. As a proportion of all injuries, shoulder injuries made up 4.2%–7.5%. Rates (0.35–5.7/1000 athlete exposures) were greater during practice (5.0/1000) than competition (2.4/1000). Multidirectional instability (33.8%, 37.7%) and musculotendinous injury (26.6%–90.9%) were the most common injury. In four studies 66.2%–100% of total shoulder injuries were acute onset. Most (59.3%) shoulder injuries were minor, 7.4% required surgery and 80% caused symptoms post-retirement. Asymmetric bars were the most frequent mechanism of shoulder injury. One study reported excessive shoulder stretching, hyperlaxity and instability as significant (p  Conclusions Shoulder injuries are a problem among female artistic gymnasts. Interventional studies reporting age and competition level-specific data may guide prevention strategy implementation.