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Shoulder injuries in wheelchair sport athletes is the most commonly reported injury site and can directly impact not only sport performance, but everyday function and mobility. There is abundant research on shoulder rehabilitation for able bodied athletes, but minimal specifically related to wheelchair sport athletes. The purpose of this paper is to outline an exercise protocol and wheelchair sport equipment fit guidelines based off current research and expert opinion. Further research is needed on the effectiveness of a wheelchair athlete specific shoulder rehabilitation protocol, and biomechanical analysis of ideal wheelchair sport equipment fit to reduce shoulder injury and optimize performance.