Medical Sciences
Shoulder-Focused Exercise for External-Rotator Capacity and Rotator-Cuff Strength Balance in Overhead Athletes: A Systematic Review and Meta-Analysis
By Habib Alismaily, Tamer Farouk Elsaid, Ibrahim Alabid and 8 others.
Abstract
Background
Shoulder-focused exercise is widely used to improve external-rotator capacity and rotator-cuff strength balance in overhead athletes, but effects may vary according to contraction mode, sport, and clinical context.
Methods
PubMed, Scopus and CENTRAL were searched from inception through 15 August 2026; SPORTDiscus and ClinicalTrials.gov were additionally searched from inception through 7 October 2026. The protocol was registered in PROSPERO (CRD420261506247). Random-effects meta-analyses used restricted maximum likelihood estimation with modified Knapp–Hartung inference. Risk of bias was assessed using RoB 2 and certainty of evidence using GRADE.