Menu

HomeHow it worksContact UsContact Us

Integrated Kinetic Chain Function in Overhead Athletes: Clinical Implications for Injury Risk, Rehabilitation, and Return to Performance.

Welch M, Osmak J. · HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2026

This review explains how overhead athletes (like baseball pitchers and volleyball players) generate power through a coordinated chain from their legs and hips up through their trunk to their shoulder and elbow, rather than relying on arm strength alone. The authors outline how injuries should be assessed and treated using this full-body perspective, with practical guidance for rehab, training, and workload management.
Takeaway: Assess and rehabilitate overhead athletes by screening their entire lower body, hips, trunk, and scapular control—not just the injured shoulder or elbow.
Abstract (source)

Overhead athletes rely on proximal-to-distal sequencing to generate, transfer, accelerate, and dissipate force during high-velocity sport actions. 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. Level of Evidence: Expert opinion level V.

Read the original →