The shoulder is one of the most commonly injured body part in pole dancing. Almost every overhead movement, grip, climb and hold places demand on the shoulder complex. Understanding what puts shoulders at risk is therefore directly relevant to how you train, how you program and when you seek help.
This edition of Pole Meets Science looks at a 2025 systematic review examining shoulder injury risk factors across athletic populations.
Study snapshot
Title: Risk factors associated with new onset of shoulder pain and injury among the athletic population
Authors: Salamh et al. (2025)
Study link: Read full article here
Study design
Systematic review conducted according to PRISMA guidelines. 5 databases were searched in October 2022. Each stage of the selection process was reviewed by multiple researchers.
Inclusion criteria:
- Athletes either pain-free or no history of shoulder pain at baseline
- Musculoskeletal shoulder/arm injuries only
- Prospective studies capturing risk factors
- Data reported as relative risk, odds and/or hazard ratios
- Follow up of over 6 months
Exclusions:
- Mixed populations without separate data
- Non-English studies
Included studies:
- 19 studies covering 7802 athletes across various sports, such as handball, baseball, tennis, swimming and military training
- 18 prospective cohort studies, 1 RCT
- 13 rated low risk of bias, 6 moderate
What they found
These variables consistently increased the risk of new shoulder pain or injury in athletic populations:
- Reduced shoulder strength, rotator cuff imbalance and weak link along the kinetic chain
- Limited or excess shoulder range of motion depending on the unique demands of each sport examined
- Previous history of injury/pain
- High or rapidly varied training loads
- Risk factors are different for each sport
Study limitations
The included studies cover overhead sports (handball, baseball, tennis, swimming) that share some characteristics with pole but are not pole. The findings are informative and directionally useful but cannot be assumed to apply identically to pole dancing without pole-specific research to validate them.
The inclusion criteria were restrictive, which improves internal validity but reduces breadth. Definitions of ‘injury’ varied across studies, making direct comparison difficult. Only English-language studies were included, which may introduce geographic and cultural bias in the populations represented.
What this means for pole dancers
Understanding and addressing the modifiable risk factors identified in this review can guide training and rehab. Our posts about rotator cuff related shoulder pain go into more detail about causes and risk factors and rehab and prevention.
Shoulder strength and rotator cuff balance
The finding about rotator cuff imbalance is one of the most actionable for pole dancers. Many pole moves load the internal rotators heavily. Without deliberate external rotation strengthening, imbalances can develop gradually over months or years of consistent training, often in the absence of any obvious symptoms until a threshold is crossed.
The kinetic chain refers to the linked system of joints and segments through which force is transferred during movement from the feet and trunk through the shoulder to the pole. A weakness anywhere in that chain, such as poor core stability, limited thoracic mobility or scapular instability increases the compensatory demand placed on the shoulder joint itself. In pole, where most movements are performed without a stable base beneath the feet, the kinetic chain demand on the shoulder is higher than in most comparable sports. This is why shoulder rehab and prehab needs to address trunk and scapular control, not just the shoulder joint in isolation.
Range of motion
This finding is particularly relevant for the pole dancer population, which has a high prevalence of hypermobility. The review found that both restricted and excessive range of motion increased injury risk, with the direction depending on the sport. For an overhead sport like pole, restricted shoulder mobility is a clear risk factor. But excessive passive mobility without the active control to manage it is equally problematic.
For hypermobile pole dancers specifically, this means that the goal is not maximising range of motion but developing strength and control throughout the available range. More passive shoulder flexibility is not inherently better, what matters is whether the active control matches the passive range.
Training load
The finding that rapid increases in load drive injury risk is consistent with what the broader sports medicine literature shows and directly applicable to pole. Common scenarios include returning after time off and resuming previous training volume too quickly, suddenly increasing training frequency when motivation is high or including off the pole conditioning alongside pole training without accounting for the cumulative load.
The practical implication is to increase training demands gradually and deliberately, to track volume and frequency in a way that makes sudden changes visible and to treat periods of increased load as requiring proportionally increased recovery.
History of pain
Prior pain in the elbow or shoulder or having a previous upper or lower extremity remain a predictor of future injury even after apparent recovery. To minimise future issues, ensure that previous injuries were properly rehabilitated, that residual strength or control deficits have been addressed and that screening for ongoing vulnerabilities is part of ongoing training management rather than a one-off event.
Putting it into practice
| Risk Area | Pole-specific check | Prevention strategy |
|---|---|---|
| Strength imbalance | Test and monitor ER/IR strength and scap control | Add rotator cuff and scapular stability drills |
| Range of motion | Assess overhead and ER/IR flexibility | Maintain balanced mobility through targeted mobility work as needed |
| Training load | Track volume/frequency and sudden changes in load | Increase load gradually and include recovery sessions |
| Previous pain | Don’t ignore niggles | Seek early physio intervention |
Our takeaway
Even in pain-free athletes, shoulder strength, mobility and training load are key factors in predicting injury risk. While no pole-specific injury prevention program currently exists, targeted screening and an individualised approach can go a long way in reducing the risk of shoulder injuries.
What’s your current approach to shoulder prehab? Do you take any active measures? Share it in the community forum. It’s a topic that comes up regularly. And if you know someone who’d find this useful, spread the word!
If you want a pole-specific shoulder screening or a prehab plan built around your training demands, virtual sessions with Polisthenics are available to book. The earlier, particularly before a problem develops, the more options there are.
We offer virtual physiotherapy, strength coaching and personalised training programs tailored to pole dancers whether you’re injured, want to avoid getting injured or want to get stronger and achieve your pole goals.
๐ป Book your appointment or message us here or on Instagram @polisthenics!
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References
Salamh, P, Bullock, G, Chester, R, Daniell, H, Cook, C, DeLang, M, Tucker, H R, Walker, D and Lewis, J. (2025). โRisk factors associated with new onset of shoulder pain and injury among the athletic population: a systematic review of the literatureโ, IJSPT, 20(3), pp. 315-332. Available at: https://ijspt.scholasticahq.com/article/129462-risk-factors-associated-with-new-onset-of-shoulder-pain-and-injury-among-the-athletic-population-a-systematic-review-of-the-literature (Accessed: 22 July 2025).
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