Comparison of Range of Motion, Strength and Proprioception of Shoulder Joint in Overhead and Non-overhead Athletes: A Cross-sectional Study

Introduction: The overhead throwing motion is a complex, highly coordinated musculoskeletal sequence that exerts multidirectional and supraphysiological stresses on the shoulders. The repetitive action causes adaptive structural modifications for the athlete to effectively conduct overhead motions. However, the modifications may lead to injuries and pain over time. Aim: To examine the difference in proprioception, Range Of Motion (ROM), and shoulder strength between overhead and non-overhead athletes. Materials and Methods: The present cross-sectional study was conducted in Vadodara, Gujarat, India from March 2023 to March 2024. Overhead and non-overhead athletes from various sports complex participated in the study. The players were above 18 years of age, played at least one hr/day, minimum three days/ week, since at least a year. Players with acute shoulder pain, shoulder and neck surgeries were excluded from the study. Nonoverhead athletes were also included for comparison. Shoulder ROM was assessed passively by using inclinometer, shoulder strength by handheld spring dynamometer and shoulder proprioception by inclinometer. Unpaired t-test was used for comparison between both groups and paired t-test was used for comparison within groups. Results: Total 160 athletes (80 overhead and 80 non-overhead athletes) participated in the study. Mean age of overhead athletes was 26.90 years and a non-overhead athlete was 26.05 years. Shoulder flexion, extension, External Rotation (ER) ROM was significantly more (p<0.001) and Internal Rotation (IR) was significantly less (p<0.001) in overhead athletes compared to non-overhead athletes. Shoulder Flexion, Extension, ER range was significantly more in dominant hand of overhead athletes (p<0.001). Shoulder strength was significantly more in nonoverhead athletes (p<0.001). Shoulder flexors, extensors and internal rotators strength was significantly more in dominant hand of overhead athletes (p<0.001). Proprioception of ER 900 was more significant in non-overhead athletes (p<0.001). There was no significant difference in shoulder proprioception with respect to dominance. Conclusion: Shoulder flexion, extension, ER ROM was significantly more in overhead athletes and shoulder strength (except external rotator strength) significantly more in dominant hand of overhead athletes compared to non-dominant hand of overhead athletes. However, non-overhead athletes had more IR range compared to overhead athletes. The shoulder strength was significantly more in non-overhead athletes compared to overhead athletes.