Shoulder pain and function in professional wheelchair tennis players

Warner, Martin, Wilson, Dave, Heller, Markus, Wood, Dan, Webborn, Nick, Veeger, DirkJan and Batt, Mark (2016) Shoulder pain and function in professional wheelchair tennis players. Engineering the Upper Limb, Institute of Mechanical Engineers, London, United Kingdom. 12 - 13 Dec 2016.

Abstract

Wheelchair use places large demands on the shoulder with up to 72% of users experiencing shoulder pain. Wheelchair users who take part in sport place additional demands the shoulder both in terms of the number of load cycles and the amplitude of forces. However, very little is known of the effects of sport participation on shoulder pain and function of wheelchair which may increase pain or provide a protective benefit for the shoulder and reduce pain. The aim of the study was to investigate the presence of shoulder pain and bilateral function of the shoulder in professional wheelchair tennis players. The presence of shoulder pain and impingement was recorded in eleven wheelchair tennis players using the Wheelchair Users Shoulder Disability Index (WUSPI) questionnaire and clinical examination. Kinematics of the scapula during humeral elevation and lowering in the scapular plane were obtained utilising the acromion marker cluster technique. A repeated measures ANOVA with main effects of side and humeral elevation angle was used to determine differences in kinematics between the dominant and non-dominant sides. Results of the self-reported shoulder pain questionnaire demonstrated participants experienced little pain that interfered with daily life with an average WUSPI score of 28 ± 13.8. Clinical examination demonstrated all impingement tests were negative for all participants. Kinematic analysis showed that the scapula was in a significantly greater posterior tilt orientation of 3.9° on the dominant side compared to the non-dominant side during humeral elevation and lowering. Although not statistically significant, the scapula was more internally rotated by 7.2° on the non-dominant side compared to the dominant side. There were no significant differences or trends between sides for scapular upward rotation. Despite the increased demands on the shoulder through sport participation and asymmetry in scapular kinematics there was an absence of pain or clinical signs of shoulder impingement within this professional sporting group. Further work is needed to understand the role of sport participation and exercise on shoulder pain and function in wheelchair users.

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Contributors

Author: Martin Warner

Author: Markus Heller

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