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

BİLGİ B., AKBULUT BAYRAK A., Beyhan H., DÜZGÜN İ.

Physical Therapy in Sport, vol.79, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 79
  • Publication Date: 2026
  • Doi Number: 10.1016/j.ptsp.2026.101919
  • Journal Name: Physical Therapy in Sport
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Keywords: Functional performance, Kinetic chain, Neuromuscular control, Upper extremity injuries
  • Hacettepe University Affiliated: Yes

Abstract

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.