[Development of a Shoulder Prevention Program for Overhead Sports: GOTS Shoulder Guard: Train Smart, Perform Strong!]

Shoulder injuries have a substantial impact on health economics in overhead sports. While prevention programs for knee injuries have already been extensively investigated, there remains a substantial research gap regarding shoulder injuries. This study aimed to develop a new, practical prevention program for shoulder injuries in overhead sports.

To develop the program, a literature search was conducted to identify evidence-based risk factors and prevention programs in overhead sports. To ensure the highest possible level of evidence, only systematic reviews and randomized controlled trials (RCTs) were included. In addition, a 25-item online survey on epidemiology, diagnostics, prevention and implementation was conducted among 30 internationally recognized prevention experts. The survey was carried out by the Prevention Committee of the Society for Orthopaedic Traumatologic Sports Medicine (GOTS). The findings were subsequently discussed by consensus and integrated into a novel prevention program incorporating established principles of exercise and training science.

Based on the results of three systematic reviews (five evidence-based, modifiable risk factors) and five RCTs (five different prevention programs, all demonstrating positive effects) as well as the expert survey (with the primary requirement being for an evidence-based, practical, and time-efficient program) and the integration of established principles of exercise and training science (circuit training methodology, progression through block periodization, and repetition numbers until muscular fatigue), the "GOTS Shoulder Guard: Train Smart, Perform Strong!" was developed. The prevention program focuses primarily on controlling scapulothoracic mobility, mobilizing the glenohumeral joint, strengthening the external rotators, mobilizing/stabilizing the kinetic chain, and stabilizing the glenohumeral joint.

The "GOTS Shoulder Guard" differs from existing prevention programs through its stronger evidence base and the application of established principles of exercise and training science. These principles allow for a more practical, time-efficient and individualized load control, taking into account the athlete's performance level and fluctuations. Further evaluation studies are required to verify the effectiveness, compliance and feasibility of the program.