Abstract :
[en] Overhead athletes solicit their shoulders with high velocity and in high range of motions. Subsequently, musculoskeletal adaptations occur after years of practice but, can even happen during a single season. Nowadays, the relationship between these adaptations and the occurrence of shoulder injuries or performance deserves to be better explored.
Athletic screening has become a usual practice, especially during the pre-season, as part of the pre-participation evaluation. A lot of assessment tools, protocols and tests have been described over the last years to assess shoulder strength, power, mobility, functionality as well as proprioception. However, it is not always easy for the trainer, the physiotherapist and/or the fitness trainer to know if what he is evaluating is useful, to choose between the tests or how to interpret them. Each tool or test has advantages and disadvantages, positive aspects and limits, that must be considered before using it. Therefore, the aim of this thesis was to critically analyze the assessment tools and tests that are currently available for shoulder evaluation in upper limb athletes.
The first chapter of this thesis describes the different tools available. They are divided into two groups: the laboratory/expertise centers’ tools and the on-field tools. The metrological qualities (reliability, validity, sensitivity etc…) of the different tools as well as their relationship with performance and/or shoulder injuries are described. The impact of age and practice on the variables measured is also explored in this chapter.
The usefulness of regular screening was also explored and demonstrated in this chapter.
The second chapter illustrates the use of the different tests and assessment tools in practice. Through the different laboratory tools, we showed the impact of specific interventions or dysfunctions on shoulder performance and/or usefulness in terms of prevention.
The third chapter is dedicated to functional testing. A critical analysis of the existing functional tests is provided by a Delphi Study. Based on the results and the limitations found, we suggested new on-field functional tests. The Serve Ball Throw, the Modified-Athletic Shoulder Test as well as the XCO Endurance Test were demonstrated as valid and reliable tests to assess shoulder function in overhead athletes.
This thesis provides up-to-date, easy to understand and applicable information for clinicians, athletes and trainers to help them make a better choice between the test and tools, performing them in a standardized way as well as interpreting their results. This way we hope to promote evidence-based practice regarding shoulder screening in the stakeholders around upper limb athletes.
