Throwing Velocity and Patient Reported Outcomes in Elite Level Handball Players After Completion of Shoulder-Pacemaker Strength Training

Inclusion Criteria: * Elite level handball players healthy and actively competing at the time of the study * Patients must be at least 18 years at the time of signing the informed consent * Pregnancy must be ruled out in the case of female participants (e.g., pregnancy test) * Patient must be available for all specified assessments throughout the study duration * All patients are required to give written informed consent before enrollment Exclusion Criteria: * age \<18, * history of type I or II shoulder instability according to the Stanmore classification12, * existing pain syndrome (defined by pain at rest or during motion that is not caused by dislocation and impedes training), * recent shoulder surgery (\<1 year). * Contraindication to SPM treatment (e.g., cardiac pacemaker) * Neurological disorders or nerve injuries causing the instability * Uncontrolled alcohol or substance abuse