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 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 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.

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 Clinical Evaluation of an Arthroscopic Knotless Suprapectoral Biceps Tenodesis Technique: Loop ’n’ Tack Tenodesis

2018 ◽  
Vol 6 (6) ◽  
pp. 232596711877978 ◽  
Author(s):  
Robert A. Duerr ◽  
Darin Nye ◽  
James M. Paci ◽  
Sam Akhavan
Keyword(s):  
Los Angeles ◽  
Shoulder Pain ◽  
Biceps Tendon ◽  
Demographic Data ◽  
Case Series ◽  
High Rate ◽  
Biceps Tenodesis ◽  
Excellent Outcome ◽  
Shoulder Score

Background: Pathology of the long head of the biceps tendon is a well-known cause of shoulder pain that is commonly managed with arthroscopic suprapectoral biceps tenodesis when conservative treatment fails. Purpose: To present an arthroscopic knotless suprapectoral biceps tenodesis technique known as “Loop ’n’ Tack” tenodesis and to report the clinical outcomes of patients with a minimum 2 years of follow-up. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of all patients who had undergone Loop ’n’ Tack tenodesis between January 2009 and May 2014 was completed. Charts were reviewed, and patients were contacted for demographic data, time from surgery, concomitant procedures, and workers’ compensation status, as well as visual analog scale for pain, American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation, and University of California, Los Angeles (UCLA) scores. Results: Complete follow-up evaluations were performed for 59 of 68 patients (87%). Mean follow-up was 43 months. A majority (88%) of patients had at least 1 additional procedure performed at the time of biceps tenodesis. The mean ASES shoulder score improved from 42.6 preoperatively to 91.0 postoperatively ( P < .001), and 54 of 59 patients (91.5%) had a good/excellent outcome, with a UCLA shoulder score >27 and ASES shoulder score >70. Three patients (5%) reported biceps cramping pain with overuse, and 2 (3.3%) reported intermittent anterior shoulder pain. No patients had developed a “Popeye” deformity at final clinical examination, and 97% reported that they were overall satisfied with the procedure. Conclusion: The Loop ’n’ Tack tenodesis technique results in a high rate of patient satisfaction, significant improvement in shoulder outcome scores, and a low incidence of postoperative pain, with no reoperations for biceps-related pathology.

scholarly journals Comparison of Sonographic Findings of the Rotator Cuff Between Diabetic and Non-diabetic Patients with Shoulder Pain

2021 ◽  
Vol 19 (1) ◽  
pp. 39-43
Author(s):  
Shashi Shekhar Shingh ◽  
Birendra Raj Joshi ◽  
Sunil S Thapa
Keyword(s):  
Rotator Cuff ◽  
Diabetic Patient ◽  
Shoulder Pain ◽  
Biceps Tendon ◽  
Supraspinatus Tendon ◽  
Diabetic Patients ◽  
Standard Protocol ◽  
Subacromial Impingement ◽  
History Of ◽  
Tendon Thickness

Background: The aim of study is to evaluate the shoulder by sonography in patients presenting with shoulder pain and correlate the findings observed with the diabetic patient. Methods: Study was done in 60 patients who presented in the Department of Orthopedics with a history of the shoulder pain. Shoulder ultrasound was performed according to standard protocol, thickness of the supraspinatus tendon, presence of the tear, biceps tendon subacromial subdeltoid effusion and subacromial impingement were assessed. Results: Of the 60 patients, 46 were male and 14 were female. Among them 15 patients were diabetics, 12 patient were male and 3 patient were female. Supraspinatus(SST) tendon thickness was greater in diabetics than in non-diabetics. Similarly, Subacromial bursal effusion, Biceps tendon effusion and Subacromial impingement were also seen in greater frequency in diabetic patients. However, no significant correlation was found between tear and the diabetes.Conclusions: There was increased supraspinatus tendon thickness, subacromial impingement, subacromial bursal effusion and biceps tendon effusion in diabetic patient compared to non-diabetic patient.Keywords: Diabetes; rotator cuff; supraspinatus tendon; ultrasound

scholarly journals Platelet-rich plasma for the improvement in shoulder function in rotator cuff disorders

2018 ◽  
Vol 5 (1) ◽  
pp. 156
Author(s):  
Shashi Kant Kumar Singh ◽  
Ankur Ojha
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Platelet Rich Plasma ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Time Interval ◽  
New Treatment ◽  
One Year ◽  
Partial Rotator Cuff Tear ◽  
Shoulder Score

<p class="abstract"><strong>Background:</strong> Among causes of shoulder pain, rotator cuff disorders are very common. The exact pathogenesis of rotator cuff tears is not clearly understood. To improve outcomes, the relatively new technique of injection of PRP is under investigation. Purpose of this study is to clinically evaluate the efficacy of new treatment of PRP injection in shoulder pain due to rotator cuff pathology.</p><p class="abstract"><strong>Methods:</strong> A prospective, observational study, on patients with shoulder pain diagnosed as rotator cuff disorders admitted in Department of Orthopaedics, RIMS, Ranchi during one year time interval (from 10th October 2016 to 09th October 2017) in the age ranging from 41 to 80 years with a mean age of 57.90 years was conducted. 20 Patients were selected for the study. Initial pre-injection score of patient taken on constant shoulder score and noted. Patient underwent intra-articular injection of PRP in shoulder joint through posterior approach under local anaesthesia. Patients were followed up at 1<sup>st</sup> post-injection day, 1 month, 3 months and 6 months after the injection.<strong></strong></p><p class="abstract"><strong>Results:</strong> Results were analysed according to constant shoulder score. In partial tear 5 (41.67%) have excellent, 6 (50%) have good and 1 (8.33%) has fair outcome on 6 months follow up and in full tear all 8 (100%) patients have poor outcome and none of the patients developed any complication.</p><strong>Conclusions:</strong> A<strong> </strong>single injection of PRP resulted in a safe, significant, sustained improvement in pain and functional outcomes for patients with refractory partial rotator cuff tear (RCT). <p> </p>

Biceps Tendon Changes Along Its Length, and With Altered Loading, in the Presence of Rotator Cuff Tears in a Rat Model

2010 ◽  
Author(s):  
Cathryn D. Peltz ◽  
Jason E. Hsu ◽  
David L. Glaser ◽  
Louis J. Soslowsky
Keyword(s):  
Mechanical Properties ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Rat Model ◽  
Biceps Tendon ◽  
Insertion Site ◽  
Shoulder Function ◽  
Optimal Treatment ◽  
Rotator Cuff Tears ◽  
Tendon Pathology

Biceps tendon pathology is commonly seen in the presence of rotator cuff tears and is often identified as a source of shoulder pain. However, the contribution of the biceps tendon to shoulder function is controversial and therefore the etiology of this pathology and its optimal treatment are unknown. Degeneration, inflammation and altered loading have all been hypothesized as possible mechanisms for biceps tendon pathologies. A previous study began to investigate the contribution of altered loading to these pathologies and showed that 4 weeks of increased loading resulted in decreased mechanical properties along the entire length of the tendon while decreased loading resulted in increased stiffness at the insertion site but decreased properties elsewhere [1]. Building on this study, the objective of the present study was to determine the effects of a longer period of altered loading along the length of the biceps tendon in order to determine where biceps tendon pathology originates following rotator cuff tears in a rat model. We hypothesized that: 1) increased loading would result in decreased mechanical and histological properties and decreased loading would result in increased mechanical properties and organization and 2) modulus and organization would increase along the length of the biceps tendon.

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