Patients and methods: The prospective, observational cohort study using a mixed-method approach was conducted between the 2019 and 2022 sports seasons. The study evaluated the medical history, including clinical data such as pain, and medical records of 237 competitive overhead athletes (152 males, 85 females; mean age: 26.6±5.8 years; range, 18 to 30 years). Physical examination included assessment of shoulder range of motion, shoulder muscle strength and functional testing. The diagnosis was confirmed by magnetic resonance imaging. Functional limitation to athletes` sports practice were evaluated using patient-reported outcome measures [Kerlan-Jobe Orthopedic Clinic (KJOC) Shoulder and Elbow Score].

Results: Shoulder injuries were documented in 65, representing nearly one-third of observed athletes. Subacromial impingement syndrome was the most common shoulder injury in each individual sport, followed by partial rotator cuff (RTC) tears. The KJOC data showed the highest functional limitation in the athletes with RTC partial tears. There was a significant relationship between shoulder dysfunction and RTC muscle imbalance, which could be a cause of the RTC partial tears.

Conclusion: Subacromial impingement syndrome is the most common shoulder injury in studied overhead competitive athletes. Functional limitations are most pronounced in athletes with RTC partial tears, and they are associated with RTC muscles` imbalance. Consideration of the study results can substantially help medical staff during in-season management of functional limitations associated with shoulder pain, as well as in the prevention of disorders caused by imbalance of the RTC muscles in overhead athletes. Keywords : Functional limitations, overhead sports, shoulder injuries, shoulder pain