Development of shoulder pain in athletes with disabilities is a common phenomenon and is multifactorial. The assessment of factors that are associated with shoulder pain is important for diagnosis, treatment progression and to analyse effectiveness of treatment within glenohumeral (GH) disorders and pathologies. Managing shoulder pain in these athletes presents a unique challenge.
The three objectives were: exploring whether elite wheelchair hockey and rugby players exhibit different characteristics of musculoskeletal shoulder-related variables, evaluating the effect of a physiotherapeutic intervention in the hockey team and evaluating the effect of physiotherapeutic intervention in combination with an occupational therapy intervention in the rugby team.
Authors – Dr Ann Cools: University Ghent University Hospital
Year of study – 2018.
The assessment of range of motion (ROM), muscle strength of the external and internal rotators, scapular position (SP), pectoralis minor length (PML), seated medicine ball throw (SMBT), forward head posture (FHP) and pain pressure threshold (PPT) was performed before and after a 12- week intervention programme. The treatable aspects of the intervention programme were: strength of the rotator cuff (RC), ROM of the GH joint, stretching of the pectoralis minor (PM) and the posterior capsule of the shoulder, self-treatment of myofascial trigger points (MTrPs) by manual pressure and correcting general posture.
The results showed that at baseline, as well as after the intervention, muscle strength of the external rotators was higher within the hockey team. The external rotation (ER)/ internal rotation (IR) ratio and upward rotation of the scapula in 90° of abduction (ABD) was higher for the dominant side within both groups. Upward rotation of the scapula in 0° of ABD was higher on the non-dominant side within the hockey team. Post-intervention the rugby team had more ROM in ER in comparison to the baseline and compared to the hockey team. The SMBT was better post-intervention within the hockey team and the FHP was smaller post-intervention within both groups.
Our intervention programme gives promising results, however, more research is needed. The wheelchair athlete may possibly benefit more from an individual programme over a longer period of time. Other important contributing factors may be accurate information and motivation.
Link to study online: here.