090 Joint hypermobility in athletes is associated with shoulder injury and shoulder pain: a systematic review and meta-analysis
Bibliographic record
Abstract
Background Joint hypermobility in athletes is associated with increased risk of knee injuries, but currently it is unclear if joint hypermobility is associated with increased risk of shoulder injuries. Objective To assess the association between joint hypermobility and shoulder injuries in athletes. Design Systematic review and meta-analysis. Odds ratios (OR) for having shoulder injuries in exposed (joint hypermobility) athletes compared with non-exposed (without joint hypermobility) athletes were estimated using a random effects meta-analysis. We performed subgroup analyses to explore the effect of sex, type of sport, sports level, study type, risk of bias, and exposure definition (generalised joint hypermobility (GJH) or shoulder joint hypermobility). Risk of bias was assessed using Newcastle-Ottawa Scale, and overall quality of evidence using Grading of Recommendations Assessment, Development and Evaluation. Setting Recreational and elite sports settings or military settings. Patients (or Participants) Athletes (all sports) and military personnel above 16 years of age. Interventions (or Assessment of Risk Factors) Exposure: GJH or shoulder joint hypermobility. Main Outcome Measurements Acute shoulder injury or activity-related shoulder pain. Results In total, 2,496 participants (31.9% females, mean age 19.9 years) from seven studies were included. Athletes with joint hypermobility were more likely to have shoulder injuries (OR = 3.41, 95% CI 1.88, 6.21, I2 = 71.5%) than athletes without joint hypermobility. Exposure definition had large impact on estimates (GJH, OR = 1.97, 95% CI 1.32, 2.94; shoulder joint hypermobility, OR = 6.79, 95% CI 3.91, 11.80; p=0.002), while remaining subgroup analyses showed no differences. The overall quality of evidence was low. Conclusions We found 3-fold higher odds of shoulder injuries among athletes with joint hypermobility compared with non-exposed athletes. Due to low quality of evidence, future research may change the effect estimate. These findings highlight the need for prevention of shoulder injuries in athletes with joint hypermobility.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.026 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.031 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".