Introduction: Due to repetitive loads, overhead athletes are exposed to a high risk of developing shoulder overuse injuries. Preventive exercise programs targeting modifiable risk factors represent a key strategy for reducing the incidence of these conditions. Purpose: The purpose of this thesis is to collect and analyze evidence from scientific literature regarding the effects of preventive exercise programs on overhead athletes. Methods: A literature search was conducted across PubMed, PEDro, and ScienceDirect databases using selected keywords and criteria. Free full-text studies published in the English language within the last 15 years were included in the review. Results: Seven studies were included in the review. The studies were designed to compare outcomes between a control group, which performed regular physical training for the respective sport, and one or two intervention groups, which performed a specific preventive exercise program. Five studies investigated the effects of preventive exercise programs on the incidence of shoulder overuse and substantial problems, while two studies examined the peak torques of the shoulder rotators and their ratios. In two studies, preventive exercise programs contributed statistically significantly to reducing the incidence of shoulder joint overuse conditions, whereas a statistically significant reduction in the prevalence of substantial conditions was observed in only one study. The exercise programs did not statistically significantly contribute to improving the baseline performance of the shoulder joint rotators. In one study, they contributed statistically significantly to the improvement of their conventional and functional ratios. Discussion and conclusion: In some studies, preventive exercise programs contributed to a reduction in the incidence of overuse conditions and the improvement of muscle performance and muscle performance ratios of the shoulder rotators. Exercise programs that included the strengthening of external rotators and exercises to improve the performance of the entire kinetic chain proved to be more effective. Direct comparison between study findings is hindered by the use of different injury definitions and methodological heterogeneity in intervention design. To more reliably substantiate the effects of preventive exercise programs, we suggest that future studies use a uniform injury definition and upgrade their standardized recording with imaging diagnostics and objective monitoring of muscle performance using isokinetic dynamometry.
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