Is There a Decrease in the Acromiohumeral Distance Among Recreational Overhead Athletes With Rotator Cuff–Related Shoulder Pain?

Abstract

Context: Recreational overhead athletes are exposed to high overload, which increases the risk of shoulder injuries. Reduction of the acromiohumeral distance (AHD) is often associated with rotator cuff–related shoulder pain (RCRSP) among the general population. However, the AHD of symptomatic shoulders of recreational athletes has not yet been compared with their asymptomatic shoulders. Objective: To compare the AHD of a symptomatic to asymptomatic shoulder at rest (0°) and 60° abduction. To establish the relationship between AHD, pain, and functional limitations of recreational athletes with RCRSP. Design: Cross-sectional study. Setting: University laboratory. Participants: A total of 45 recreational overhead athletes with RCRSP were examined. Main Outcome Measures: The AHD was measured by ultrasonography at 0° and 60° abduction (angles). Shoulder pain was assessed using a numeric pain scale, whereas functional limitations were assessed using the The Disabilities of the Arm, Shoulder, and Hand questionnaire. Differences in the between-shoulders condition (symptomatic and asymptomatic) were determined using 2-way analysis of variance for repeated measures. A Pearson correlation established the relationship between AHD, pain, and functional limitations. Results: No angles × shoulder condition interactions (P = .776) nor shoulder condition effects (P = .087) were detected, suggesting no significant differences (P > .05) between asymptomatic and symptomatic shoulders in the AHD at 0° or 60°. The AHD at 60° reduced significantly compared with 0° (3.05 [1.36] mm [2.77–3.33], angle effects: P < .001). The AHD at 0° and 60° was not correlated with pain or functional limitations (−.205 ≤ r ≤ .210, .167 ≤ P ≤ .585). Conclusions: The AHD of recreational athletes is not decreased in symptomatic shoulders compared with asymptomatic shoulders. Reduction of the AHD in symptomatic shoulders is not associated with an increase in pain or functional limitations of recreational athletes with RCRSP.

Etiologic Factors of Rotator Cuff Disease in Elderly: Modifiable Factors in Addition to Known Demographic Factors

“…Although RCD can decrease the AHD, the AHD of the symptomatic shoulder in recreational athletes is not significantly decreased [ 49 ]. A decrease in the AHD in symptomatic shoulders is not significantly associated with increased pain or functional limitations in recreational athletes [ 49 ]. If overhead activity occurs repetitively, especially in athletes, one can assume that RCD could be developed [ 50 ].…”

Exercise for rotator cuff tendinopathy: Proposed mechanisms of recovery

“…Subacromial impingement is no longer considered the primary mechanism in RC tendinopathy now. 6,9,21–25 Cross-sectional studies have explored supraspinatus tendon thickness in RC tendinopathy 22,23,50,71–76 (see Supplemental Table 2). The majority of the studies report increased tendon thickness with RC tendinopathy.…”

“…13,14,[16][17][18][19][20] However, impingement as the primary mechanism of RC tendinopathy is called into question, with the biomechanical evidence limiting the possibility of RC tendon compression and the lack of superior outcomes for surgical and non-surgical management focused on reducing tendon impingement over other interventions. 6,9,[21][22][23][24][25] The mechanical model of tendon injury provides just that, a biomechanical model devoid of other explanatory factors. 26,27 The muscle-tendon unit is controlled by high-order centers in the nervous system.…”

Quantitative Analysis of Dynamic Subacromial Ultrasonography: Reliability and Influencing Factors

“…Until now, there have been two major types of dynamic ultrasound methods for SIS assessment. The first is used to measure the acromiohumeral distance at fixed angles of arm abduction ( de Oliveira et al, 2020 ). The second is used to observe the deformation of the subacromial soft tissue or reciprocal position of the humeral head in relation to the acromion during shoulder elevation ( Bureau et al, 2006 ).…”

“…The second is used to observe the deformation of the subacromial soft tissue or reciprocal position of the humeral head in relation to the acromion during shoulder elevation ( Bureau et al, 2006 ). The main disadvantage of the first approach is that the acromiohumeral distance determined under static conditions (such as 0° and 60° of shoulder abduction) is incapable of reproducing abnormalities seen during shoulder movements ( de Oliveira et al, 2020 ). However, although the second approach allows the detection of uncoordinated subacromial motion ( Bureau et al, 2006 ), its application in clinical assessment and follow-up is limited by the semi-quantitative nature of the grading scenario ( Chang et al, 2016 ; Chang et al, 2017 ).…”