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Exclusion criteria were (1) included contact injuries, (2) lower extremity, spine and hand injuries, and (3) full report not published in English.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen studies were identified, and they included 3314 overhead athletes (baseball (74.6%), softball (3.1%), handball (16.1%), tennis (2.0%), volleyball (2.0%) and swimming (2.2%)). Female athletes are unrepresented (12% of the overall sample). Study quality ranged from 11 to 18 points on a modified Downs and Black checklist (maximum score 21, better quality). In one study, swimmers with low (&lt;93\u00b0) or high (&gt;100\u00b0) shoulder external rotation were at higher risk of injuries. Using data pooled from three studies of professional baseball pitchers, we showed in the meta-analysis that shoulder external rotation insufficiency (throwing arm &lt;5\u00b0 greater than the non-throwing arm) was associated with injury (odds ratio=1.90, 95% confidence interval 1.24 to 2.92, p&lt;0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preseason screening of shoulder external rotation ROM may identify professional baseball pitchers and swimmers at risk of injury. Shoulder ROM screening may not be effective to identify handball, softball, volleyball and tennis players at risk of injuries. The results of this systematic review and meta-analysis should be interpreted with caution due to the limited number of studies and their high degree of heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>PROSPERO registration number<\/jats:title><jats:p>CRD42017072895.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjsports-2019-100698","type":"journal-article","created":{"date-parts":[[2020,1,14]],"date-time":"2020-01-14T22:29:57Z","timestamp":1579040997000},"page":"1019-1027","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":80,"title":["Preseason shoulder range of motion screening and in-season risk of shoulder and elbow injuries in overhead athletes: systematic review and meta-analysis"],"prefix":"10.1136","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6384-9605","authenticated-orcid":false,"given":"Federico","family":"Pozzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3282-2538","authenticated-orcid":false,"given":"Hillary A","family":"Plummer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Shanley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2487-1399","authenticated-orcid":false,"given":"Charles A","family":"Thigpen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chase","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7785-4221","authenticated-orcid":false,"given":"Melissa L","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori A","family":"Michener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,14]]},"reference":[{"key":"2024101110251424000_54.17.1019.1","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-46.2.206"},{"key":"2024101110251424000_54.17.1019.2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.4085\/1062-6050-47.2.149","article-title":"Risk factors associated with shoulder pain and disability across the lifespan of competitive swimmers","volume":"47","author":"Tate","year":"2012","journal-title":"J Athl Train"},{"key":"2024101110251424000_54.17.1019.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2011.01398.x"},{"key":"2024101110251424000_54.17.1019.4","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2003.005785"},{"key":"2024101110251424000_54.17.1019.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.023184"},{"key":"2024101110251424000_54.17.1019.6","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/sms.12636","article-title":"Incidence and risk factors of injuries in Brazilian elite handball players: a prospective cohort study","volume":"27","author":"Giroto","year":"2017","journal-title":"Scand J Med Sci Sports"},{"key":"2024101110251424000_54.17.1019.7","doi-asserted-by":"crossref","unstructured":"Norton R , Honstad C , Joshi R , et al . 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