Background Youth around the globe place their shoulders at risk for injury when participating in sports. Shoulder injuries may vary in severity, produce the potential for time-loss from sport, and result in functional disability. Objective To explore youth sport-related shoulder injuries by identifying injury rates, risk factors, injury mechanisms, and injury prevention strategies. Design Systematic review. Setting All relevant full-text articles identified from searching MEDLINE, EMBASE, CINAHL, Sport Discus, and Cochrane Controlled Trials Registry (no date restrictions; final search August 3rd, 2021) Participants All full-text studies reporting original research describing the burden of sport-related shoulder injury among female and/or male youth from 5 to 18 years old. Studies were excluded if they were synthesis/review papers, were small case series (<10 participants), the participants included >10% adult participants; or if the full-text was not available. Main Outcome Measures Injury rates, risk factors, injury mechanisms, and injury prevention modalities as they relate to youth sport-related shoulder injuries. Results Of 3,889 studies screened, 97 described shoulder injury in youth sport. Shoulder injuries were identified in 23 unique sports. Median seasonal prevalence of shoulder injury was 10.9% (range 1.2-28.2%). The most common injury mechanisms identified were contact with another player, contact with the playing environment, and falling to the ground. Risk factors for shoulder injury identified were side-to-side strength imbalances, weak external rotator muscles, and scapular dyskinesia. Two studies evaluated successful training strategies to prevent shoulder injury, but two others demonstrated no effect. Conclusions Sport-related shoulder injuries are prevalent among youth athletes. Injury risk factors identified included modifiable intrinsic factors such as strength, range-of-motion, and training load. The most common injury mechanism was direct contact with either another person or an object in the playing environment. Innovative shoulder-specific strategies are needed to reduce shoulder injuries in this population.
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