Background: Shoulder impingement syndrome (SIS) is a prevalent condition among overhead athletes, often managed through therapeutic exercise interventions. However, the quality of reporting in exercise protocols significantly impacts their reproducibility and clinical implementation. The Consensus for Exercise Reporting Template (CERT) provides a standardized framework to assess the quality of exercise reporting in clinical research. Objectives: This systematic review aimed to evaluate the quality of exercise protocols used to treat SIS in overhead athletes by applying the CERT checklist. Additionally, the risk of bias was assessed to determine the methodological rigor of included studies. Methods: A systematic review was conducted following PRISMA guidelines. Six electronic databases (MEDLINE, CINAHL, Sport Discuss, Web of Science, and Cochrane) were searched for eligible studies. Inclusion criteria encompassed randomized controlled trials (RCTs), cohort studies, and case series that investigated exercise therapy for SIS in overhead athletes. Studies had to be published in English and provide details on exercise interventions. Exclusion criteria included non-human studies, acute injuries, and postoperative management. The primary outcome was the quality of intervention reporting, assessed using the CERT checklist. The secondary outcome was the risk of bias, evaluated using the modified Downs and Black checklist. Results: Five studies met the inclusion criteria, comprising four RCTs and one case series. CERT scores ranged from 6 to 13 (median = 8, IQR = 1), indicating suboptimal reporting quality. Commonly reported CERT items included equipment usage and exercise tailoring. However, key aspects such as adherence, motivation, and intervention fidelity were consistently underreported. None of the included studies provided comprehensive details on exercise interventions as per CERT guidelines, limiting their reproducibility and clinical application. Conclusions: The quality of reporting on exercise-based interventions for SIS in overhead athletes remains insufficient. Critical gaps in adherence monitoring, patient motivation, and intervention fidelity were identified. Future research should prioritize standardized and detailed reporting of exercise interventions to enhance reproducibility and facilitate evidence-based clinical practice.

With the global increase in women’s participation in running, understanding factors like footwear in performance and injury prevention has become essential. Minimalist shoes (MSs) and traditional shoes (TSs) influence muscle activation patterns, affecting running technique. Proper coordination of the core muscles is essential for efficient stride and posture. This study analyzed muscle activation in nulliparous women running in MSs and TSs at different speeds and explored the correlations with age and BMI. A crossover clinical trial assessed the EMG activation of the lumbar erector (LE), gluteus maximus (GM), pelvic floor, and internal oblique (IO) muscles during treadmill running at 6, 9, and 11 km/h. Fifty-one healthy women (26.55 ± 5.11 years; body mass index (BMI): 21.29 ± 2.07 kg/m²) participated. The protocol included a warm-up, 30 s runs at each speed, and a 5-minute washout between trials. The statistical analyses included Wilcoxon, Friedman, and Spearman’s correlation tests. GM and IO showed the highest activation (p < 0.001) regardless of the footwear or speed. No significant differences were found between MSs and TSs. Weak-to-moderate correlations emerged between BMI and LE muscle activation with MSs, and between BMI and IO with both footwear. Significant correlations were also found with IO activations, but none with PF muscles. The correlations between personal variables, shoe types, and muscle activation suggest that individual and external factors may influence neuromuscular modulation, impacting injury prevention and personalized interventions.

Introduction: Deep dry needling (DDN) is commonly applied in physiotherapy to treat musculoskeletal pain. The quadratus femoris (QF) muscle, located in the ischiofemoral space (IFS), represents a clinically relevant yet anatomically complex target. However, limited evidence exists on the safety, accuracy, and reliability of non-ultrasound-guided DDN in this region. Aims: To assess the safety and accuracy of a standardized, non-ultrasound-guided DDN approach to the QF muscle, and to evaluate the intra- and inter-rater reliability of key procedural outcomes. Additionally, to determine the agreement between ultrasound imaging and anatomical dissection as validation methods for needle placement. Methods: An experimental cross-sectional study was conducted on five fresh cadavers (n = 24 approaches) by two physiotherapists with different DN experience. A standardized dry needling protocol was executed without ultrasound guidance, and anatomical and procedural variables were documented. Reliability (intra/inter-rater) was assessed for needle size, sciatic nerve (SN) puncture, IFS targeting, and overall success. In a subset, needle placement was validated through ultrasound and subsequent dissection. Results: The IFS was reached in 70.8% of procedures, and the SN was punctured in 16.7%. Inter-rater reliability for needle size was poor (κ = 0.04). Agreement between ultrasound and dissection was excellent for the ischiofemoral location and success (100%) and moderate for non SN puncture (90%; κ = 0.62). Conclusions: The standardized protocol demonstrated moderate accuracy and revealed a relevant clinical risk when targeting the quadratus femoris muscle. While inter-rater reliability was limited, agreement between ultrasound and dissection methods was high, supporting their complementary use for validating needle placement in anatomically complex procedures.

Background and Objectives: CrossFit is a discipline involving a wide range of overhead movements performed at high intensity and under accumulated fatigue that predispose to a high risk of shoulder complex injuries. This study aimed to compare ultrasonographic findings between symptomatic and asymptomatic shoulders in CrossFit athletes. Materials and Methods: A cross-sectional study was conducted to compare ultrasound parameters between the painful and non-painful shoulders in CrossFit athletes with unilateral subacromial shoulder pain. Assessed variables included subacromial subdeltoid bursa thickness, supraspinatus tendon thickness, the acromiohumeral distance, the coracoacromial ligament distance, the bicipital groove angle, cross-sectional area of the biceps brachii longus head tendon, as well as the serratus anterior and lower trapezius muscle thickness. Results: Twenty male CrossFit athletes (forty shoulders) with an average age of 25.70 ± 4.03 years participated in the study. A statistically significant increase was observed (p < 0.05) in the subacromial subdeltoid bursa thickness in the painful shoulder compared to the asymptomatic side. All other ultrasound parameters did not show statistically significant differences. Conclusions: Only subacromial subdeltoid bursa thickness differed significantly between sides. This isolated finding may not fully explain shoulder pain, which cannot be solely attributed to morphological changes. Further research is needed to determine the relationship between shoulder pain and ultrasound features in CrossFit athletes, as well as the role of ultrasound in predicting structural changes in pain conditions.

Subacromial shoulder pain is one of the most common musculoskeletal conditions affecting overhead athletes, particularly those engaged in high-intensity training modalities such as CrossFit. The prevalence of shoulder injuries in this population continues to rise due to increased participation, repetitive overhead movements, and biomechanical stress on the rotator cuff and scapular stabilisers. While various rehabilitation approaches exist, no consensus exists on the most effective exercise intervention for improving shoulder function and pain outcomes in athletes with subacromial shoulder pain. Current rehabilitation protocols for overhead athletes lack specificity, failing to address the sport-specific demands and movement patterns that may contribute to persistent pain and dysfunction. This study compares the effectiveness of a sport-specific exercise programme versus a scapular stability programme in improving clinical and functional outcomes in CrossFit athletes with subacromial shoulder pain. This study follows a randomised controlled trial (RCT) design, adhering to Consolidated Standards of Reporting Trials and Standard Protocol Items: Recommendations for Interventional Trials guidelines for intervention-based trials. Outcome assessments will include validated patient-reported outcome measures, objective strength and mobility tests, and biomechanical performance metrics. Participants will be recruited from sports clinics and CrossFit training centres across Madrid, ensuring a representative sample of athletes experiencing shoulder pain.

Introduction: Hip range of motion (ROM) across various planes is necessary in sport-related activities. Static stretching was commonly used to improve hip ROM. The Lightback system, a novel compression device, has been developed to enhance hip mobility by applying controlled axial forces on the femur. This study aimed to evaluate the effectiveness of the Lightback system in improving hip ROM and posterior chain flexibility compared to conventional static stretching. Methods: A randomized cross-over trial was carried out in 31 physically active participants (62 lower limbs; n = 31 Lightback group (LBG) and n = 31 stretching group (SG)). Hip rotation at two positions of hip flexion (active and passive external (ER) and internal rotation (IR) at 0–90° hip flexion), total rotation ROM (TRROM), and the flexibility of the posterior chain (active knee extension test (AKE) and active straight leg raise (ASLR)) were measured before and after the stretching session. Results: LBG demonstrated significantly greater improvements in hip ER and IR compared to the SG. Specifically, the LBG showed significant increases in active ER at 0° (p = 0.002) and 90° (p < 0.001) of hip flexion, as well as IR at 0° (p = 0.007) and 90° (p < 0.001). TRROM in neutral and at 90° of hip flexion also improved significantly in the LBG (p < 0.001). In passive ROM, the LBG exhibited significant increases in ER at 0° (p < 0.001), IR at 90° (p = 0.001), and TRROM at both positions (p < 0.001), compared to the SG. Regarding posterior chain flexibility, both groups improved in AKE and ASLR (p < 0.001), but the LBG showed a significantly larger effect in ASLR (p < 0.001), with no significant difference between groups in AKE. Conclusion: This study demonstrated that both the Lightback system and static gluteal stretching improved passive hip ROM. However, the Lightback system showed greater improvements in active ROM, particularly in external and internal rotation at various degrees of hip flexion, as well as in posterior chain flexibility. Notably, the Lightback system significantly enhanced large improvement in the ASLR test.