Predictive role of surface electromyography and shoulder kinematic analysis on injury risk in padel players: A proof-of-concept study

Objective: Padel, a high-intensity overhead sport, poses significant shoulder injury risks due to repetitive motions and microtrauma. This study utilized an inertial motion unit (IMU) and surface electromyography (sEMG) to identify kinematic and muscle activation patterns distinguishing injury-prone and non-prone players, emphasizing prehabilitation's role in preventing shoulder injuries and enhancing performance. Methods: Male padel players with >= 5 years of experience were assessed at the Rehabilitation Unit of the University Hospital "Renato Dulbecco" of Catanzaro, Italy, Participants were stratified into high-risk and low-risk groups based on prior shoulder tendinopathies. Surface electromyography (sEMG) and IMU were used to measure muscle activation and movement smoothness during flexion, abduction, and rotation movements. Results: The high-risk group exhibited increased mean jerk during abduction (p < 0.05), indicative of reduced movement smoothness. Muscle activation analysis showed significant overactivation of the biceps brachii and under-activation of the trapezius during shoulder movements. Infraspinatus activation was significantly lower during rotation in the high-risk group (p < 0.001). ROC analysis identified predictive cut-offs for injury risk: mean jerk >2.51, deltoid activation <46%, trapezius activation <30.6%, biceps brachii activation >13%, and infraspinatus activation >25.7%, with sensitivity and specificity exceeding 83% for most parameters. Conclusions: This study highlights the utility of combining IMUs and sEMG for biomechanical and physiological evaluation in padel players. The findings suggested that decreased movement fluidity and muscle activation imbalances may increase the risk of shoulder injuries. Future longitudinal studies should focus on broader athletic motions, larger sample sizes to refine injury prevention and rehabilitation strategies for padel players.