scholarly journals Clinical and ultrasonographic evaluation of shoulder in elite waterpolo players a cross-sectional study

2019 ◽  
Author(s):  
Andrea Ruberti ◽  
Mario Ronga ◽  
Leonardo Callegari
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Structural Changes ◽  
Biceps Tendon ◽  
Power Doppler ◽  
Statistical Correlation ◽  
Cross Sectional ◽  
Structural Alterations ◽  
Overhead Throwing ◽  
Shoulder Score

Abstract Background: Rotator cuff structural changes are common in overhead throwing athletes, such as baseball, javelin, swimming, volleyball, by increasing the risk of shoulder pain and injury. The structural alterations in elite waterpolo players are not well known. In elite waterpolo athletes there are structural alterations of rotato cuff tendons due to overuse of the dominant shoulder compared to the non-dominant, like in oth er overhead disciplines, identifiable by ultrasound (US). Methods: Asymptomatic elite men waterpolo players were selected. All athletes were evaluated with standardized scales of shoulder pain and function (Oxford Shoulder Score, Constant Shoulder Score) and provided data of training, injury and shoulder pain history. Each athlete underwent clinical evaluation of shoulders followed by US of rotator cuff, biceps and bursas. Results : 23 athletes met the inclusion criteria, mean age 24.2±3.3. 14 athletes (60.9%) presented higher degeneration grade at the dominant supraspinatus compared to the contralateral, always in the same area in outfield pla yers: anterior, lateral, pre-insertional. In 22/23 (95.6%) the biceps tendon was damaged: 20/23 athletes (87%) bilaterally, 2/23 (8.7%) at the only dominant limb. The site was always at the bicipital groove in its insertion on the humerus. Power Doppler (PD) evidenced neovascularization in only 5/23 (21.7%) players at supraspinatus: 4 bilaterally, 1 only at the non-dominant. No statistical correlation was found between tendon degeneration and age, career years. Conclusion: Outfield waterpolo players have peculiar changes in supraspinatus at preinsertional level, as seen in other overhead throwing athletes. We found changes also in biceps, bilaterally, like in shoulders of elite swimmers. We suppose that these changes are predictive of shoulder pain and injury.

scholarly journals Clinical and ultrasonographic evaluation of shoulder in elite waterpolo players a cross-sectional study

2019 ◽  
Author(s):  
Andrea Ruberti ◽  
Mario Ronga ◽  
Leonardo Callegari
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Structural Changes ◽  
Biceps Tendon ◽  
Power Doppler ◽  
Statistical Correlation ◽  
Cross Sectional ◽  
Structural Alterations ◽  
Overhead Throwing ◽  
Shoulder Score

Abstract Background: Rotator cuff structural changes are common in overhead throwing athletes, such as baseball, javelin, swimming, volleyball, by increasing the risk of shoulder pain and injury. The structural alterations in elite waterpolo players are not well known. In elite waterpolo athletes there are structural alterations of rotato cuff tendons due to overuse of the dominant shoulder compared to the non-dominant, like in oth er overhead disciplines, identifiable by ultrasound (US). Methods: Asymptomatic elite men waterpolo players were selected. All athletes were evaluated with standardized scales of shoulder pain and function (Oxford Shoulder Score, Constant Shoulder Score) and provided data of training, injury and shoulder pain history. Each athlete underwent clinical evaluation of shoulders followed by US of rotator cuff, biceps and bursas. Results : 23 athletes met the inclusion criteria, mean age 24.2±3.3. 14 athletes (60.9%) presented higher degeneration grade at the dominant supraspinatus compared to the contralateral, always in the same area in outfield pla yers: anterior, lateral, pre-insertional. In 22/23 (95.6%) the biceps tendon was damaged: 20/23 athletes (87%) bilaterally, 2/23 (8.7%) at the only dominant limb. The site was always at the bicipital groove in its insertion on the humerus. Power Doppler (PD) evidenced neovascularization in only 5/23 (21.7%) players at supraspinatus: 4 bilaterally, 1 only at the non-dominant. No statistical correlation was found between tendon degeneration and age, career years. Conclusion: Outfield waterpolo players have peculiar changes in supraspinatus at preinsertional level, as seen in other overhead throwing athletes. We found changes also in biceps, bilaterally, like in shoulders of elite swimmers. We suppose that these changes are predictive of shoulder pain and injury.

scholarly journals Clinical and Imaging evaluation of rotator cuff tendons in Elite Waterpolo player

2021 ◽  
Author(s):  
Andrea Ruberti ◽  
Leonardo Callegari ◽  
Mario Ronga
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Structural Changes ◽  
Biceps Tendon ◽  
Power Doppler ◽  
Statistical Correlation ◽  
Imaging Evaluation ◽  
Structural Alterations ◽  
Overhead Throwing ◽  
Shoulder Score

Abstract Background: Rotator cuff structural changes are common in overhead throwing athletes, such as baseball, javelin, swimming, volleyball, by increasing the risk of shoulder pain and injury. The structural alterations in elite waterpolo players are not well known. In elite waterpolo athletes there are structural alterations of rotator cuff tendons due to overuse of the dominant shoulder compared to the non-dominant, like in other overhead disciplines, identifiable by ultrasound (US).Methods: Asymptomatic elite men waterpolo players were selected. All athletes were evaluated with standardized scales of shoulder pain and function (Oxford Shoulder Score, Constant Shoulder Score) and provided data of training, injury and shoulder pain history. Each athlete underwent clinical evaluation of shoulders followed by US of rotator cuff, biceps and bursas. Results: Twenty-three athletes met the inclusion criteria, mean age 24.2±3.3. Fourteen athletes (61%) presented higher degeneration grade at the dominant supraspinatus compared to the contralateral, always in the same area in outfield players: anterior, lateral, pre-insertional. In twenty-two (95%) the biceps tendon was damaged: Twenty athletes (87%) bilaterally, two (9%) at the only dominant limb. The site was always at the bicipital groove in its insertion on the humerus. Power Doppler (PD) evidenced neovascularization in only five (22%) players at supraspinatus: four bilaterally, one only at the non-dominant. No statistical correlation was found between tendon degeneration and age, career years.Conclusion: Outfield waterpolo players have peculiar changes in supraspinatus at preinsertional level, as seen in other overhead throwing athletes. We found changes also in biceps, bilaterally, like in shoulders of elite swimmers. We suppose that these changes are predictive of shoulder pain and injury.

scholarly journals Ultrasonographic Evaluation of the Shoulders and Its Associations with Shoulder Pain, Age, and Swim Training in Masters Swimmers

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 29
Author(s):  
Yuta Suzuki ◽  
Noriaki Maeda ◽  
Junpei Sasadai ◽  
Kazuki Kaneda ◽  
Taizan Shirakawa ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Structural Changes ◽  
Partial Tear ◽  
Increased Risk ◽  
High Prevalence ◽  
History Of ◽  
Long Head ◽  
Competitive Swimmers ◽  
Rotator Cuff Tendinopathy

Background and objectives: The long head of the biceps (LHB) and rotator cuff tendinopathy is the major cause of shoulder pain in competitive swimmers. The risk of tendinopathy increases with aging; however, the structural changes of LHB and rotator cuff in populations of masters swimmers have not been well examined. The purpose of this study was to investigate the prevalence of ultrasonographic abnormalities of the shoulders in masters swimmers, and the association of pain, age, and swim training with structural changes in this population. Materials and Methods: A total of 60 subjects participated in this study, with 20 masters swimmers with shoulder pain, 20 asymptomatic masters swimmers, and 20 sex- and age-matched controls. All swimmers completed a self-reported questionnaire for shoulder pain, their history of competition, and training volume. Each subject underwent ultrasonographic examination of both shoulders for pathologic findings in the LHB tendon, rotator cuff (supraspinatus (SSP) and subscapularis (SSC)) tendons, and subacromial bursa (SAB) of both shoulders and had thickness measured. Results: The prevalence of tendinosis (LHB, 48.8%; SSP, 17.5%; SSC, 15.9%), partial tear (SSP, 35.0%), and calcification (SSC, 10.0%) were higher in swimmers than in controls. LHB and SSP tendinosis were associated with shoulder pain. Older age and later start of competition were associated with an increased risk of LHB tendinosis and SSC calcification. Earlier initiation of swimming and longer history of competition were associated with an increased risk of SSP and SSC tendinosis. The thicker SSP tendon significantly increased the risk of tendinosis and partial tear. Conclusions: A high prevalence of structural changes in the rotator cuff and biceps tendons in masters swimmers reflects the effect of shoulder symptoms, aging, and swim training.

Is rotator cuff related shoulder pain a multidimensional disorder? An exploratory study

2020 ◽  
Vol 20 (2) ◽  
pp. 297-305 ◽  
Author(s):  
Luca Maestroni ◽  
Michele Marelli ◽  
Massimiliano Gritti ◽  
Fabio Civera ◽  
Martin Rabey
Keyword(s):  
Rotator Cuff ◽  
Pain Intensity ◽  
Shoulder Pain ◽  
Management Strategies ◽  
Future Research ◽  
Multivariable Model ◽  
Cross Sectional ◽  
Need To Evaluate ◽  
Symptom Persistence ◽  
Multivariable Regression Models

AbstractBackground and aimsRotator cuff related shoulder pain has been associated with factors from multiple dimensions such as strength changes, psychosocial measures, comorbidities and level of education. However, to date little research has been undertaken to evaluate which factors explain the greatest variance in pain and disability levels in people with rotator cuff related shoulder pain. The objective of this study was therefore to evaluate which multidimensional examination findings were associated with higher pain and disability in a primary care cohort with rotator cuff related shoulder pain.MethodsThis was an exploratory cross-sectional cohort study. Sixty-seven participants with rotator cuff related shoulder pain were assessed for: pain intensity, disability; demographic, psychological, social and lifestyle characteristics, and isometric strength of shoulder internal and external rotator muscles. Univariable associations between pain intensity/disability and each variable were assessed using linear regression. Variables with univariable associations (p < 0.1) were entered into backwards stepwise multivariable regression models.ResultsThe multivariable model for pain intensity included sleep and perceived persistence and explained 46.5% of the variance (37.6% uniquely by sleep, 5.4% uniquely by perceived persistence). The multivariable model for disability included sleep and sex and explained 26.8% of the variance (4.5% shared by predictors, 16.4% uniquely by sleep, 5.9% uniquely by sex).ConclusionsRotator cuff-related shoulder pain and disability are associated with sleep disturbance, perceived symptom persistence and sex. Rotator cuff related shoulder pain may be considered a multidimensional disorder.ImplicationsClinicians need to evaluate sleep and perceived symptom persistence in people with rotator cuff related shoulder pain. Future research may examine whether management strategies for RCRSP directed towards these factors afford improved treatment outcomes.

What happens to the long head of the biceps tendon after arthroscopic rotator cuff repair?

2020 ◽  
Vol 102-B (9) ◽  
pp. 1194-1199
Author(s):  
Hyo-Jin Lee ◽  
Eung-Sic Kim ◽  
Yang-Soo Kim
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Biceps Brachii ◽  
Morphological Changes ◽  
Biceps Tendon ◽  
Cross Sectional ◽  
Postoperative Changes ◽  
Long Head ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Aims The purpose of this study was to identify the changes in untreated long head of the biceps brachii tendon (LHBT) after a rotator cuff tear and to evaluate the factors related to the changes. Methods A cohort of 162 patients who underwent isolated supraspinatus with the preservation of LHBT was enrolled and evaluated. The cross-sectional area (CSA) of the LHBT on MRI was measured in the bicipital groove, and preoperative to postoperative difference was calculated at least 12 months postoperatively. Second, postoperative changes in the LHBT including intratendinous signal change, rupture, dislocation, or superior labral lesions were evaluated with seeking of factors that were correlated with the changes or newly developed lesions after rotator cuff repair. Results The postoperative CSA (12.5 mm2 (SD 8.3) was significantly larger than preoperative CSA (11.5 mm2 (SD 7.5); p = 0.005). In total, 32 patients (19.8%) showed morphological changes in the untreated LHBT 24 months after rotator cuff repair. Univariate regression analysis revealed that the factor chiefly related to the change in LHBT status was an eccentric LHBT position within the groove found on preoperative MRI (p = 0.011). Multivariate analysis using logistic regression also revealed that an eccentric LHBT position was a factor related to postoperative change in untreated LHBTs (p = 0.011). Conclusion The CSA of the LHBT inside the biceps groove increased after rotator cuff repair. The preoperative presence of an eccentrically positioned LHBT was associated with further changes of the tendon itself after rotator cuff repair. Cite this article: Bone Joint J 2020;102-B(9):1194–1199.

scholarly journals Prevalence and Grading of Rotator Cuff and Labral Injuries in Shoulder Pain and Instability using MRI: ACross-sectional Study

2021 ◽  
Author(s):  
Ashok Srikar Chowdhary ◽  
Naresh Babu Lakshmipathi Nikhil ◽  
Nidhi Hemendra Chandrakar ◽  
Nidhi Raj Buddaraju
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Biceps Tendon ◽  
Supraspinatus Tendon ◽  
Sectional Study ◽  
Rotator Cuff Injuries ◽  
Rotator Cuff Injury ◽  
Biceps Pulley ◽  
Study Population ◽  
Long Head

Introduction: Shoulder joint is a highly mobile joint but is prone for rotator cuff injuries and dislocations. It is necessary to accurately diagnose rotator cuff and labral injuries so that appropriate plan of action for treatment can be taken. Magnetic Resonance Imaging (MRI) can be used to diagnose and describe the extent of rotator cuff tendon and labral injuries and any secondary rotator cuff muscle abnormalities. Aim: To study the demographic profile of patients presenting with shoulder pain and instability, identify the various rotator cuff injuries causing shoulder pain, identify the rotator cuff interval lesions causing microinstability, identify the various labral and bony pathologies in instability, describe the MRI features of the rotator cuff, rotator cuff interval, labral and bony injuries. Materials and Methods: This study was a cross-sectional study of patients with symptoms of either shoulder pain or instability who underwent MRI evaluation of the shoulder in the Department of Radiodiagnosis, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India, from July 2018 to December 2020. The study population consisted of 54 patients with either shoulder pain or instability who underwent MRI of shoulder. All the MRI scans of the shoulder in this study were performed using 1.5 Tesla Siemens Magnetom Avanto (Tim 76x18) MR machine using a flex coil. Results: The study population consisted of 54 patients comprising of 38 males and 16 females. The age of the patients ranged from 20-77 years. Majority of the patients were older than 50 years constituting about 33.33% of the total study population. Rotator cuff injury was the commonest cause of pain. Tendinosis was the commonest type of rotator cuff injury followed by partial-thickness and full-thickness tendon tears. The commonest grade of tendinosis was mild or grade 1. Supraspinatus tendon was the most commonly affected tendon followed by subscapularis and infraspinatus tendons. Teres minor tendon was normal in all the cases. Anterior instability was the commonest type of instability with equal prevalence of soft tissue Bankart, bony Bankart and Perthes lesions. Biceps pulley lesions resulted in long head of biceps tendon instability, microinstability and internal impingement. Conclusion: Rotator cuff injuries are the commonest cause of shoulder pain and are seen more frequently after the fifth decade. Shoulder instability is most commonly seen in young male adults. Tendinosis is the commonest type of rotator cuff injury. Supraspinatus tendon is the most commonly injured tendon. Anterior instability is the commonest type of shoulder instability. Biceps pulley lesions result in long head of biceps tendon instability, microinstability and internal impingement. MRI can diagnose interstitial or intrasubstance tendon tears which are not visualised on arthroscopy. MRI description of tendon and labral tears, tendon retraction and muscle atrophy can guide the orthopaedician during arthroscopy and in treatmentplanning.

scholarly journals Does a relationship exist between the number of training or competition hours and the presence of sonographic alterations in the shoulder of CrossFit athletes?

2019 ◽  
Vol 02 (01) ◽  
pp. 09-17
Author(s):  
Claudia Juan Vigar ◽  
Francesc Medina-Mirapeix
Keyword(s):  
Shoulder Pain ◽  
Structural Changes ◽  
Demographic Data ◽  
Injury Rate ◽  
Clinical History ◽  
Clinical Findings ◽  
Ac Joint ◽  
Cross Sectional ◽  
Long Head ◽  
Sonographic Pattern

Introduction CrossFit is a sport that is on the rise and has a known injury rate thanks to studies that have affirmed that the shoulder is the area that suffers the most damage. To date, no objective tool has been used to evaluate this. The aim of the present study was to determine the frequency of structural sonographic alterations in CrossFit athletes and its relationship with accumulated hours of practice and/or competition in the sport and shoulder pain. Material and Methods A cross-sectional descriptive study was conducted with sonographic assessments performed on 208 shoulders of 104 participants at official CrossFit gyms in Barcelona, between April and May 2017. The participants were requested to complete a specific questionnaire on CrossFit sports practice that included demographic data, the existence of pain, data on training routines, and clinical history. Ultrasound (US) examinations were made on the supraspinatus tendons (SST), on the long head of the biceps (LHB), and on the acromioclavicular (AC) joint. Results The presence of focal hypoechoic areas (FHAs) in the LHB (48.1%) and in the SST (60.6%) were the most common alterations in this sample, whereas, at the level of the AC joint, the most common disorder was the presence of cortical defects (30.3%). Shoulder pain was present in 37.5% of the participants. The probability of experiencing pain increased when the athletes accumulated > 1,000 hours of training (odds ratio [OR] = 2.0). In these athletes, the probability of presenting a focal hypoechoic area (FHA) decreased in the LHB (OR = 0.3), and the width of the SST increased a mean of 0.5 mm (p < 0.01). In athletes who participated in competitions, the sonographic pattern also presented an increased width of the SST and LHB tendons; however, this was not related with an increased probability of experiencing pain. Conclusions The sonographic pattern of the shoulder of CrossFit athletes presented structural changes in the SST and LHB tendons when subjects accumulated > 1,000 hours of training or when they participated in competitions. It is essential to relate the sonographic findings with the clinical findings of a patient to define whether these findings are, indeed, pathological. The probability of experiencing pain in the shoulder doubles when > 1,000 hours of CrossFit training are accumulated. This finding bears no relation with competing.

scholarly journals Quantitative Ultrasonographic Analysis of Changes of the Suprascapular Nerve in the Aging Population With Shoulder Pain

2021 ◽  
Vol 9 ◽  
Author(s):  
Wei-Ting Wu ◽  
Lan-Rong Chen ◽  
Hsiang-Chi Chang ◽  
Ke-Vin Chang ◽  
Levent Özçakar
Keyword(s):  
Rotator Cuff ◽  
Older People ◽  
Brachial Plexus ◽  
Shoulder Pain ◽  
Supraspinatus Tendon ◽  
Suprascapular Nerve ◽  
Control Group ◽  
Full Thickness ◽  
Cross Sectional ◽  
Rotator Cuff Lesions

BackgroundOlder people are vulnerable to painful shoulder syndromes, the majority of which are derived from degenerative rotator cuff pathologies. The suprascapular nerve (SSN) is closely related to the rotator cuff complex, and its role in shoulder pain has recently been highlighted. This study aimed to explore the differences in SSN among older people with and without shoulder pain, and to investigate the potential factors influencing the nerve size using ultrasound (US) imaging.MethodsParticipants aged ≥60 years were enrolled in the study. A systematic and bilateral US examination of the rotator cuff tendons was performed. The SSN was examined from its origin in the brachial plexus to the spinoglenoid notch of the infraspinatus fossa. The association between the nerve’s cross-sectional area (CSA) and rotator cuff lesions was analyzed using the generalized estimation equation.ResultsAmong the 94 participants, 45 (with bilaterally asymptomatic shoulders) were classified into the control group, whereas 49 (with at least one-sided shoulder pain) were classified into the group with shoulder pain. The average CSAs of the SSN at the level of the brachial plexus, supraspinatus fossa, and infraspinatus fossa were comparable between the patients in the control group and those with shoulder pain. There was a higher prevalence of rotator cuff lesions and enlarged distal SSNs in the painful shoulders than in the asymptomatic shoulders of patients with unilateral involvement. A full-thickness tear of the supraspinatus tendon was associated with swelling of the SSN in the supraspinatus fossa (β coefficient = 4.068 mm2, p &lt; 0.001).ConclusionIn the older population, full-thickness tears of the supraspinatus tendon are independently associated with enlargement of the distal SSN. In cases with large rotator cuff tendon tears with poor response to conservative treatments, possible SSN entrapment should be considered and managed accordingly.

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