Shoulder pain and ultrasound findings: A comparison study of wheelchair athletes, nonathletic wheelchair users, and nonwheelchair users

Abstract

Background: Shoulder pain is one of the most common musculoskeletal concerns in manual wheelchair users including among athletes. However, there is a paucity of research characterizing both shoulder pain and shoulder pathology in this population. Objective: To characterize and compare the prevalence of current shoulder pain and ultrasound metrics of shoulder pathology between wheelchair athletes, nonathletic wheelchair users, and nonwheelchair users. Design: Cross-sectional. Setting: Chicago-area adaptive sport teams/programs and musculoskeletal clinics. Participants: Thirty-four wheelchair athletes, six nonathletic wheelchair users, and 12 nonwheelchair users. Methods: Self-reported shoulder pain was assessed by questionnaire and Wheelchair User Shoulder Pain Index (WUSPI). Shoulder physiology and pathology were assessed by physical and ultrasound evaluation of both shoulders by a sports medicine physician. Main Outcome Measures: Questionnaire outcomes: Prevalence of current shoulder pain, total WUSPI score. Physical examination outcomes: total Physical Examination of Shoulder Scale (PESS) score. Sonographic outcomes: Acromiohumeral distance (AHD) and presence of shoulder pathology. Results: The majority of wheelchair athletes (68%) and nonathletic wheelchair users (67%) experienced shoulder pain since using a manual wheelchair. Wheelchair basketball players had a mean WUPSI score of 17.2 (SD = 21.8), and athletes participating in handcycling, sled hockey, and quad rugby had mean scores of 4.91 (SD = 8.32), 7.76 (SD = 13.1), and 4.29 (SD = 7.75), respectively. Shoulder pathology was observed in 14 of 31 (45%) wheelchair athletes and 4 of 6 (67%) nonathletic wheelchair users (p = .41). Conclusions: Although wheelchair use is a risk factor for shoulder pain, participation in amateur wheelchair sports may not be associated with increased risk of shoulder pain. It is possible that overhead sports such as wheelchair basketball may define a unique high-risk group. Further study is needed to examine this relationship and to determine whether there are differences between specific wheelchair sports.

What’s New in Orthopaedic Rehabilitation

“…Soo Hoo et al investigated the prevalence of current shoulder pain and ultrasound metrics of shoulder pathology between wheelchair athletes, non-athletic wheelchair users, and non-wheelchair users 36 . The authors found that the majority of both athletic and non-athletic wheelchair users experienced shoulder pain, leading them to conclude that amateur wheelchair sports do not seem to be associated with an increased risk of shoulder pain, although overhead sports such as wheelchair basketball may represent a unique high-risk group.…”

Could the Improvement of Supraspinatus Muscle Activity Speed up Shoulder Pain Rehabilitation Outcomes in Wheelchair Basketball Players?

“…A recent scoping review states that SP prevalence in WB players can reach the threshold of 75% [5]. Among the SP causes in WB players, rotator cuff tendinopathies seem to be the most frequent trigger [6]. In particular, since WB is an overhead sport, the supraspinatus tendon is the most exposed to lesions and thus is primarily responsible for the appearance of SP [7], also contributing to scapular dyskinesias, which results in further limitations of daily wheelchair use [8].…”