ObjectivesRotator cuff-related shoulder pain (RCRSP) is a common upper limb complaint. It has been suggested that this condition is more common among people with cardiometabolic risk factors. This systematic review has synthesised evidence from case–control, cross-sectional and cohort studies on the association between metabolic syndrome (MetS) and RCRSP.Design and data sourcesFive medical databases (MEDLINE, EMBASE, SCOPUS, CINAHL and AMED) and reference checking methods were used to identify all relevant English articles that considered MetS and RCRSP. Studies were appraised using the Newcastle-Ottawa Scale (NOS). Two reviewers performed critical appraisal and data extraction. Narrative synthesis was performed via content analysis of statistically significant associations.ResultsThree cross-sectional, two case–control and one cohort study met the inclusion criteria, providing a total of 1187 individuals with RCRSP. Heterogeneity in methodology and RCRSP or MetS definition precluded a meaningful meta-analysis. Four of the included studies identified associations between the prevalence of MetS and RCRSP. Studies consistently identified independent cardiometabolic risk factors associated with RCRSP. All studies were level III evidence.Summary and conclusionThe low-moderate quality evidence included in this review suggests an association between MetS and RCRSP. Most studies demonstrated moderate quality on appraisal. The direction of association and cardiometabolic factors influencing should be investigated by longitudinal and treatment studies. These preliminary conclusions and clinical utility should be treated with caution due to limitations of the evidence base.

To cite: Burne G, Mansfield M, Gaida JE, et al. Is there an association between metabolic syndrome and rotator cuffrelated shoulder pain? A systematic review.

OVERHEAD PHYSICAL PERFORMANCE OF THE UPPER LIMB IS PREDICATED ON VARIOUS FACTORS INCLUDING PROPRIOCEPTION, KINESTHESIA, AND MUSCLE ACTIVITY AROUND THE GLENOHUMERAL AND SCAPULOTHORACIC JOINTS. SUSTAINING SUFFICIENT NEUROMUSCULAR CONTROL ALLOWS OPTIMAL PERFORMANCE TO OCCUR, WHILE REDUCING RISK OF INJURY. CONVERSELY, BOTH FACTORS ARE REDUCED IN THE PRESENCE OF AN INJURY SHOWING THEIR IMPORTANCE IN REHABILITATION. OVERHEAD PERTURBATION TRAINING ALLOWS CONTROLLED EXPOSURE OF THE ATHLETE TO POSITIONS OF VULNERABILITY TO ALLOW FACILITATION OF ADAPTIVE RESPONSES TO IMPROVE RESPONSE TO EXTERNAL PERTURBATIONS OF LIMB POSITION. THIS TECHNIQUE ALLOWS DEVELOPMENT OF NEUROMUSCULAR CONTROL PATTERNS THAT MAY REDUCE INJURY.