A critical appraisal of "Sling-based exercise for external rotator muscles: effects on shoulder profile in young recreational tennis players"

Critical appraisal is an important skill necessary for physical therapists to learn and analyze potentially new clinical skills, techniques or to develop new questions for further research. This appraisal focuses on the question, "Can regular rotator cuff strength training in adolescent overhand athletes decrease risk of later shoulder capsular injury compared to those that do not"�? Critical appraisal requires asking questions with clinical implications using the PICO format and searching databases for relevant studies by focusing on key words such as "young"� and "rotator cuff"�. The article "Sling-based Exercise for External Rotator Muscles: Effects on Shoulder Profile in Young Recreational Tennis Players"� focuses on the question best and was chosen for appraisal. The study is based on the risk factor for rotator cuff-based injury where the principle kinematics are to force the arm into extreme internal/external rotation and the implementation of sling-based exercise to eliminate contralateral imbalances in strength and range of motion deficits. Overall the study is of high quality with limitations such as limited subject size and diversity, lack of fundamental background on sling-based exercise, individual results, and redundancy of results in discussion. Though the limitations exist, it would be recommended for clinical implementation with further research of intervention.