Prevalence of shoulder problems in adolescent handball players: systematic review and meta-analysis

Background: Young handball players are at a higher risk of becoming injured because of factors associated with their growth, such as the growth spurt, vulnerability of the growth plate, and different physiological reaction to training and match load. Objective: To investigate the prevalence of shoulder injuries in adolescent handball players. Methods: A systematic search was conducted using the electronic databases Medline Complete, PubMed, Sport Discus, Cinahl, and Scopus. The risk of bias for each included study was evaluated using the Joanna Briggs Institute Prevalence Critical Appraisal Tool. The I² statistic was utilized to evaluate the heterogeneity between studies and combine the estimated prevalence and incidence of shoulder injuries in adolescent handball athletes. Results: The analysis included six studies: five prospective cohort studies and one cross-sectional study, involving 933 adolescent handball players (353 females, 479 males). The overall season prevalence was 25.8% (confidence interval [CI] 18.3–64.4%). Prediction intervals suggest future prevalence could range from 6.3% to 64.4%. The Q‑value was 190.833 (10 df, p < 0.001), indicating the null hypothesis of a common effect size can be rejected. The I² statistic was 95%, indicating most variance is true between studies rather than sampling error. Sensitivity analysis showed results stable regardless of study removal. Subgroup analysis revealed significant differences (Q = 115.405, df = 3, p = 0.001), except for the overuse injury group (p = 0.416). Shoulder pain had the highest prevalence at 42.3% (CI 15–75.3%), while substantial problems had the lowest at 14.4% (CI 3.9–40.9%). Conclusion: Studies show a high prevalence of shoulder problems among young handball athletes, underscoring the need for effective injury management and prevention strategies. With many athletes experiencing shoulder pain, it is crucial for coaches, trainers, and healthcare providers to implement targeted interventions to reduce overuse injuries and promote long-term health. Raising awareness and providing tailored preventive measures are essential for ensuring a healthier environment for young players.