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Although shoulder and elbow symptoms are often managed locally, the literature supports an integrated kinetic chain framework that views upper-extremity loading and performance as the product of interactions among the lower extremities, lumbopelvic-hip complex, trunk, scapulothoracic articulation, and neuromuscular control systems. The purpose of this narrative review is to discuss integrated kinetic chain function in overhead athletes and to outline practical implications for assessment, rehabilitation, strength and conditioning, workload management, and return to performance.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Level of Evidence:<\/jats:bold>\n                    Expert opinion level V.\n                  <\/jats:p>","DOI":"10.1177\/15563316261485302","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:01:59Z","timestamp":1789099319000},"page":"558-563","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated Kinetic Chain Function in Overhead Athletes: Clinical Implications for Injury Risk, Rehabilitation, and Return to Performance"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9250-7923","authenticated-orcid":false,"given":"Mathew","family":"Welch","sequence":"first","affiliation":[{"name":"Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Osmak","sequence":"additional","affiliation":[{"name":"Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2012.04.005"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.023218"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5919(05)70260-X"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/17461391.2013.773090"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.02.021"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2015.11.015"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-20-06-364"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.058834"},{"key":"e_1_3_2_10_2","first-page":"853037","article-title":"Kinetic chain rehabilitation: a theoretical framework","volume":"2012","author":"Sciascia A","year":"2012","unstructured":"Sciascia A, Cromwell R. 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