Shoulder Mechanics and Injury Risk in Aerial Acrobatics: From Load Patterns to Recovery Pathways

The shoulder joint is the most mobile, but also the most vulnerable link in the biomechanical chain of the upper extremity, which is especially evident in conditions of increased load when performing aerial acrobatics elements. The article presents a holistic anatomical and biomechanical review of the structures of the shoulder complex and characterizes the main mechanisms of injury that occur during dynamic and static elements with support on the upper extremities. The typical range of peak loads for different grip variants (true, cup, twisted) and their relationship with the shoulder position are analyzed. Particular attention is paid to preventive strategies, in particular, eccentric strengthening of the shoulder rotators, stabilization of the scapula, and training load management. The second part offers a step-by-step four-phase model of rehabilitation after functional overload, with clear criteria for transitioning between phases. The final section outlines the prospects for research on anatomical, hormonal, and gender moderators of injury, with an emphasis on the need for standardization of methodology for meta-analytic reviews. Objective. To form an integrated resource covering the anatomy of a shoulder, functional biomechanics during training by aerial acrobatics, to develop coaching tips, and to study the epidemiology of injuries. Research methods. Narrative synthesis (PubMed, Scopus, Web of Science 2015 2025) in combination with the expert experience of the Chief International Judge of the IPSF.