Abstract
BACKGROUND: Given the high incidence of shoulder injuries among quarterbacks due to the repetitive stress of the overhead throwing motion, there is a need for targeted, sport-specific assessments that reflect the functional demands of throwing. The Athletic Shoulder (ASH) test, previously validated in rugby and baseball populations, offers a potential solution for upper extremity strength assessment in football quarterbacks. The primary purpose of this case series was to explore the feasibility of conducting the ASH test as a method for evaluating upper extremity strength in overhead athletes, specifically collegiate quarterbacks. STUDY DESIGN: Case series. METHODS: Three NCAA Division I quarterbacks participated in weekly ASH testing over a nine-week period. Peak isometric force, peak force normalized to body weight, and limb symmetry indices were measured in the shoulder "Y" and "T" positions using portable force plates. Testing was completed pre-practice on non-game days to minimize fatigue effects and maintain consistency. RESULTS: The dominant shoulder consistently produced greater peak force than the non-dominant side in both Y and T positions. The mean dominant-to-non-dominant limb symmetry index was 1.13 in the Y position and 1.14 in the T position. Within limbs, peak force was greater in the Y position than in the T position. In both positions and in both arms, athletes generated at least 14% of their body weight in force on average. CONCLUSION: These findings can provide insight into strength asymmetries and functional performance benchmarks, enabling strength coaches, athletic trainers, and rehabilitation professionals to fine-tune training and rehabilitation programs. Incorporating the ASH test into a standardized assessment battery may enhance the ability to evaluate an athlete's readiness to train or compete, promoting a proactive approach to performance optimization and injury prevention. Its utility and actionable metrics make the ASH test a practical tool for in-season monitoring, allowing practitioners to make informed, data-driven adjustments throughout the season. LEVEL OF EVIDENCE: Level 4.