Relationship between Shoulder Pain, Trunk and Lower Limb Pain in Overhead Athletes: A Systematic Review with Meta-analysis.
Marine Leroux, Franck Lagniaux
PMID 39628781WHAT IT FOUND
Overhead athletes with trunk, hip, knee, or ankle/foot pain were two to five times more likely to also report shoulder pain.
This is association, not proof that one pain caused the other.
Key findings
01Shoulder pain was significantly associated with back pain, hip pain, knee pain, and ankle/foot pain in pooled analyses.
02Overhead athletes with trunk or lower limb pain appeared two to five times more likely to also have shoulder pain.
03The certainty of evidence was low for shoulder pain with back or knee pain, and very low for shoulder pain with hip or ankle/foot pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Most included studies were cross-sectional, so they can show association at one time point but not cause. The evidence was rated low or very low by GRADE. Pain was measured with self-reported questionnaires, which may introduce recall bias and inconsistent definitions. Risk of bias was high in two studies and some concerns in five, partly because confounders were not consistently considered. The athletes were young, aged seven to 28, and not representative of all overhead athletes. One included study combined shoulder and elbow pain. This may have affected the shoulder pain results.
The easy way to misread this
Do not conclude that trunk or lower limb pain causes shoulder pain, or that treating those areas will prevent shoulder pain. The review mostly combined cross-sectional self-reported studies, and the evidence was low to very low.