Does Scapular Positioning Predict Shoulder Pain in Recreational Overhead Athletes?

Abstract

The objective of this prospective study is to investigate possible scapular related risk factors for developing shoulder pain. Therefore, a 2-year follow-up study in a general community sports centre setting was conducted. A sample of convenience of 113 recreational overhead athletes (59 women and 54 men) with a mean age of 34 (17-64; SD 12) years were recruited. At baseline, visual observation for scapular dyskinesis, measured scapular protraction, upward scapular rotation and dynamic scapular control were evaluated. 22% (n=25) of all athletes developed shoulder pain during the 24 months following baseline assessment. The Mean Shoulder Disability Questionnaire (SDQ) score for the painful shoulders was 34.8 (6.3-62.5; SD 17.4). None of the scapular characteristics predicted the development of shoulder pain. However, the athletes that developed shoulder pain demonstrated significantly less upward scapular rotation at 45° (p=0.010) and 90° (p=0.016) of shoulder abduction in the frontal plane at baseline in comparison to the athletes that remained pain-free. In conclusion, although these scapular characteristics are not of predictive value for the development of shoulder pain, this study increases our understanding of the importance of a scapular upward rotation assessment among recreational overhead athletes.

Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis

“…For example, the results of the two studies performed on adolescent athletes are contrasting 34 35. Likewise, the one study performed on recreational athletes has a similar point estimate, although with wider 95% CI, when compared with the pooled RR 37. However, due to the small number of studies overall subgroup analysis is not appropriate.…”

“…However, one study performed follow-up at 12 and 24 months 37. All studies utilised self-reporting of shoulder pain/injuries.…”

“…Serial administration of standardised questionnaires was used in two studies. The Shoulder Disability Questionnaire was administered at 12 and 24 months by Struyf et al 37. The Oslo Sports Trauma Research Centre injury questionnaire was administered every 2 weeks throughout the season by Clarsen et al 24…”

Scapular dyskinesis was not associated with pain and function in male adolescent athletes

“…Such research ensures that ORIGINAL ARTICLE DOI 10.5935/2595-0118.20180009 changes in scapular kinematics may result in structural and functional changes in the glenohumeral and acromioclavicular joints, decreased subacromial space, changes in the scapular muscles activation and, consequently, leading to dysfunctions such as shoulder-rotator cuff syndrome, rotator cuff tendinopathies, glenohumeral instability, and other conditions. On the other hand, there is evidence that scapular asymmetries are also observed in asymptomatic subjects, and for this reason, it is not possible to clearly and accurately infer a cause-effect relationship between pain and dyskinesis, making it impossible to state which of these factors precedes the other [12][13][14][15][16] . It is noteworthy that a good part of these studies [12][13][14][15][16] , stating that there is a relationship between pain and dyskinesis, refers to the adult population or high-level competition athletes, which, possibly, by the repetitive motor movements and training overload may make this association more evident.…”

“…On the other hand, there is evidence that scapular asymmetries are also observed in asymptomatic subjects, and for this reason, it is not possible to clearly and accurately infer a cause-effect relationship between pain and dyskinesis, making it impossible to state which of these factors precedes the other [12][13][14][15][16] . It is noteworthy that a good part of these studies [12][13][14][15][16] , stating that there is a relationship between pain and dyskinesis, refers to the adult population or high-level competition athletes, which, possibly, by the repetitive motor movements and training overload may make this association more evident. Thus, it is possible to speculate if younger athletes, and with fewer sports requirements, would behave similarly to previous studies, but evidence that supports this inquiry is still insufficient 17,18 .…”