Pressure pain hypersensitivity and referred pain from muscle trigger points in elite male wheelchair basketball players

Abstract

BackgroundShoulder injuries are common in individuals who use wheelchairs. ObjectivesThis study investigated the presence of mechanical pain hypersensitivity and trigger points in the neck-shoulder muscles in elite wheelchair basketball players with/without shoulder pain and asymptomatic able-bodied elite basketball players. MethodsEighteen male wheelchair basketball players with shoulder pain, 22 players without shoulder pain, and 20 able-bodied elite male basketball players were recruited. Pressure pain thresholds were assessed over C5-C6 zygapophyseal joint, deltoid muscle, and second metacarpal. Trigger points in the upper trapezius, supraspinatus, teres minor, infraspinatus, teres major, latissimus dorsi, subscapularis, pectoralis minor, pectoralis major and deltoid muscles were also examined. ResultsWheelchair basketball players with shoulder pain showed lower pressure pain thresholds over the C5-C6 joint and second metacarpal than elite wheelchair basketball players without pain (between-groups differences: 1.1, 95%CI 0.4, 1.8 and 1.8, 95%CI 0.8, 2.8, respectively) and able-bodied basketball players without pain (between-groups differences: 0.8, 95%CI 0.4, 1.2; 1.6, 95%CI 0.8, 2.4, respectively). The mean number of myofascial trigger points for wheelchair basketball players with unilateral shoulder pain was 4.8±2.7 (2±1 active, 2.9±2.2 latent). Wheelchair basketball players and able-bodied basketball players without shoulder pain exhibited a similar number of latent trigger points (2.4±2.0 and 2.4±1.8, respectively). Wheelchair basketball players with shoulder pain exhibited higher number of active myofascial trigger points than those without pain (either with or without wheelchair), but all groups had a similar number of latent trigger points (P<0.05). ConclusionsThe reported mechanical pain hypersensitivity suggests that active trigger points may play a role in the development of shoulder pain in elite male wheelchair basketball players.