Risk Factors For Shoulder Pain Research Articles

Shoulder pain prevalence and risk factors in middle-aged women: A cross-sectional study

PurposeThe aim of the current study was to investigate the prevalence of shoulder pain and to explore the possible associated risk factors in middle-aged women. MethodsA total of 500 middle-aged women, aged 45–65 years, participated in this cross-sectional study. The point and lifetime prevalence of shoulder pain were calculated. Linear and logistic regressions were used to determine the possible associations between the risk factors and present shoulder pain. ResultsThe point and lifetime prevalence of shoulder pain were 18.6% and 27.6%, respectively. The logistic regression analysis demonstrated a significant association between present shoulder pain and history of shoulder pain and trauma, osteoporosis, trapezius muscle pain, and cervical radiculopathy (p < 0.05). However, there was no significant association between present shoulder pain and diabetes mellitus or postural deviation (p > 0.05). ConclusionThe results indicated that shoulder pain has considerable prevalence in middle-aged women. In addition, a history of shoulder pain and trauma, osteoporosis, trapezius muscle pain, and cervical radiculopathy were found to be associated with present shoulder pain. Future research should concentrate on longitudinal designs that explore preventive strategies and risk factors for shoulder pain.

Shoulder extension strength: a potential risk factor for shoulder pain in young swimmers?

ObjectivesTo determine the relationship and predictive value of isometric shoulder strength in the development of shoulder pain in young swimmers. DesignProspective, cohort study. MethodsShoulder flexion, extension, external and internal rotation strength tests were performed in elevation on 85 swimmers (14–20 years; 48 females) without current shoulder pain using a hand-held dynamometer. Following testing, swimmers were emailed questionnaires to determine if significant shoulder pain developed within 24 months subsequent to testing. The differences between shoulders that did and did not develop pain and the predictive ability of shoulder strength and strength ratios were investigated using Mann Whitney U tests and receiver operating characteristic curves. ResultsThirty-seven swimmers (47%) returned questionnaires and 18 reported shoulder pain. A comparison of individual shoulders (27 with pain reported and 47 without) determined that shoulder extension strength was lower and flexion:extension strength ratio was higher for male swimmers (n=36 shoulders) who reported shoulder pain compared to those who did not (p=0.04). The predictive value of extension strength was fair (0.72; p=0.03) for males with a cut-off value for extension strength calculated at 13.5% body mass. There were no differences between the two groups in shoulder rotation strength, age, training hours or previous pain history. ConclusionsShoulder extension strength, a functional test for swimmers, was associated with and predictive of the development of shoulder pain in male swimmers. Low shoulder extension strength may be a risk factor for the development of shoulder pain in swimmers, proposing a direction for injury prevention and future investigation.

Risk Factors for Shoulder Pain in Japanese Badminton Players: A Quantitative-Research Survey

Risk Factors for Shoulder Pain in Japanese Badminton Players: A Quantitative-Research Survey

Physical Therapy Intervention in Post Stroke Shoulder Subluxation: A Narrative Review

Objective: The purpose of this narrative review is to summarize the recent advances in Glenohumeral subluxation (GHS) treatment approaches. Background: Glenohumeral subluxation (GHS) subluxation is found 81% of the individuals following stroke, a preventable secondary complication often accompanied with poor upper limb function. GHS is also considered as an important risk factor for shoulder pain and other problems. GHS is a complex phenomenon with very little understanding of its pathomechanics. Method: The literature was obtained by searching in computerized database. Evidence was obtained from articles published in peer-reviewed journal and published in English language. Discussion and Conclusion: Ultrasound measurements are considered the best method of quantifying GHS. Clinical evaluation such as finger-breadth method and sulcus sign can be useful and quick clinical assessment tool. Novel methods such as Functional electrical stimulation and tapping method are effective in an acute stage of hemiplegia and arm slings have been shown a negative impact on rehabilitation of GHS, However, it shall be used for a shorter period of time.

Risk Factors for Shoulder Pain in a Cohort of French Workers: A Structural Equation Model.

Shoulder pain is common in the working population and causes loss of productivity, high economic costs, and long absences. Simultaneous evaluation of the complex relationships between work organization (e.g., work pace, application of quality standards), psychosocial and physical risk factors, stress, and shoulder pain is rare. The aim of this study was to explore the direct and indirect relationships between workplace risk factors, perceived stress, and occurrence of shoulder pain in workers of the Cohorte des Salariés Ligériens study. A total of 3,710 workers in a French region were randomly selected for inclusion between 2002 and 2005. They completed a self-administered questionnaire about musculoskeletal symptoms, individual factors, and exposure to work constraints. In 2007, they responded to a follow-up questionnaire. The study sample comprised 1,400 workers free of shoulder pain at baseline. Structural equation models were used. For both sexes, exposure to factors related to work organization had an effect on physical and psychosocial risk factors. Psychological demand was the only psychosocial constraint that increased perceived stress. Shoulder pain was influenced directly by physical risk factors for both sexes and by perceived stress for men. In view of their distal action, work organization is an important target for strategies to prevent shoulder pain in the working population.

Risk factors for shoulder pain and injury in swimmers: A critical systematic review

Swimming is one of the most popular recreational and competitive sporting activities. In the 2013/2014 swimming season, 9630 men and 12,333 women were registered with the National Collegiate Athletics Association in the USA. The repetitive nature of the swimming stroke and demanding training programs of its athletes raises a number of concerns regarding incidence and severity of injuries that a swimmer might experience during a competitive season. A number of risk factors have previously been identified but the level of evidence from individual studies, as well as the level of certainty that these factors predispose a swimmer to pain and injury, to our knowledge has yet to be critically evaluated in a systematic review. Therefore, the primary objective of this review is to conduct a systematic review to critically assess the published evidence for risk factors that may predispose a swimmer to shoulder pain and injury. Three electronic databases, ScienceDirect, PubMed and SpringerLink, were searched using keywords “(Injury OR pain) AND (Swim*)” and “(Shoulder) AND (Swim*)”. Based on the inclusion and exclusion criteria, 2731 unique titles were identified and were analyzed to a final 29 articles. Only articles with a level of evidence of I, II and III were included according to robust study design and data analysis. The level of certainty for each risk factor was determined. No studies were determined to have a high level of certainty, clinical joint laxity and instability, internal/external rotation, previous history of pain and injury and competitive level were determined to have a moderate level of certainty. All other risk factors were evaluated as having a low level of certainty. Although several risk factors were identified from the reviewed studies, prospective cohort studies, larger sample sizes, consistent and robust measures of risk should be employed in future research.

Risk factors for shoulder pain in patients with spinal cord injury: a multicenter study.

Shoulder pain in spinal cord injury (SCI) is common due to the repetition of the wheelchair propulsion and the increased intra-articular pressure during transfers. Known risk factors for the onset of shoulder pain are age and level of SCI. Aims of this study were to assess how body mass index affects the onset of shoulder pain and to evaluate the relationship between the age at the moment of SCI and the number of years between SCI and the onset of shoulder pain. A retrospective study was performed including subjects with SCI between C5 and S3. Excluding criteria were spina bifida and subjects not using manual wheelchair or presenting with shoulder pain before SCI. Patients in the two spinal cord units were reviewed with a self-made questionnaire, and patients were also enrolled during sport events. Age at the moment of SCI, current age and number of years between SCI and the onset of shoulder pain were recorded. Ninety-six patients were enrolled: 77 men and 19 women; 46.4 % reported shoulder pain. Overweight patients who do more than 12 transfers per day showed an increased incidence of shoulder pain (p = 0.0434). A linear regression showed a significant relationship between the age of the subject at the moment of SCI and the number of years between the SCI and the onset of pain. Our study confirms that age and level of SCI are risk factors for shoulder pain, but we demonstrated also that overweight patients who do more than 12 transfers per day have higher chances of having shoulder pain.

Shoulder Symptoms and Function in Geriatric Patients

Musculoskeletal problems, including shoulder pain, are common in the general population and are often cited as reasons for physician visits. Although many risk factors for shoulder pain are postulated, the effects of shoulder pain on functional level and perceived quality of life are poorly characterized in older adults. In this study, we set out to determine the prevalence and impact of shoulder symptoms and dysfunction in an older adult veteran population. A chart review, cross-sectional survey, and examination were performed. A sample of 93 individuals, aged 60 years or older, was recruited from a primary clinic outpatient waiting room at the Clement J. Zablocki VA Medical Center in Milwaukee, Wisconsin. Patients were asked about shoulder symptoms and self-assessed health and completed the Stanford Modified Health Assessment Questionnaire. A series of 3 shoulder maneuvers was used to assess shoulder mobility and pain. The presence of diabetes and statin use was documented. A more thorough chart review was performed on individuals who reported shoulder pain and disability. Severe shoulder pain was common in the study group, reported by 31% of all participants. Functional limitation measured by the Modified Health Assessment Questionnaire and answering "yes" to greater difficulty performing daily tasks was associated with reduced internal rotation, which was present in almost 36% of all participants. Symptoms were often bilateral. No statistically significant risk factors emerged in this small sample, but suggestive trends were apparent. Interestingly, few patients reported discussing these problems with their providers, and shoulder-related problems were documented in only 10% of corresponding problem lists of symptomatic patients. With an aging population, the high prevalence of shoulder pain may have considerable impact on public health. It will become increasingly important to define risk factors, delineate etiologies, and devise new management strategies for patients with symptomatic shoulder disease.

Work with prolonged arm elevation as a risk factor for shoulder pain: A longitudinal study among young adults

This prospective study aimed at examining if work with prolonged arm elevation predicts shoulder pain among 41 young adults in their first years of working life. Fifteen hairdressers, 15 electricians, 5 students and 6 with various work were followed over a 2.5-year period (2006/7–2009). Arm elevation was measured with inclinometers during a full working day at baseline. Shoulder pain was reported at baseline and twice in the follow-up period. Data were analyzed by generalized estimating equations (GEE-analysis), stratified by gender and adjusted for time, mechanical workload, work demand, physical activity, tobacco use and prior shoulder pain. Work with prolonged arm elevation with angles >60° and >90° were associated with shoulder pain among women. Even though the shoulder pain levels are low the study suggests work with arms elevated as an early work-related risk factor among women, and indicates the importance of early prevention strategies.

Prevalence of freestyle biomechanical errors in elite competitive swimmers.

Background:Poor freestyle stroke biomechanics is a suggested risk factor for shoulder pain and pathology, but this has not been proven in biomechanical or clinical studies. Furthermore, the prevalence of these theoretical errors has not been identified, which would help coaches, athletic trainers, and researchers determine the most appropriate errors to focus on and develop interventions.Hypothesis:The majority of swimmers will present with at least 1 freestyle stroke error.Study Design:Cross-sectional study.Level of Evidence:Level 4.Methods:Stroke biomechanics for 31 swimmers from a collegiate swimming team were captured using underwater/above-water cameras. Each video was evaluated for biomechanical errors: a dropped elbow during the pull-through phase, a dropped elbow during the recovery phase, an eyes-forward head-carrying angle, incorrect hand position during hand entry, incorrect hand entry angle, incorrect pull-through pattern, and inadequate body roll. Error prevalence was calculated, and relationships among the errors were evaluated using chi-square statistics.Results:A dropped elbow during the pull-through phase (61.3%) and a dropped elbow during the recovery phase (53.2%) had the highest prevalence. A dropped elbow during the recovery phase was significantly associated with a thumb-first hand entry angle (P = 0.027) and incorrect hand entry position (P = 0.009). An eyes-forward head-carrying angle was associated with an incorrect pull-through pattern (P = 0.047).Conclusion:Biomechanical errors potentially detrimental to the shoulder are prevalent among swimmers. Many of the errors were interrelated, suggesting that one error may lead to other errors.Clinical Relevance:These errors highlight the need for proper stroke instruction and evaluation to decrease the risk of shoulder injury in competitive swimmers.

Prevalence and risk factors for work-related shoulder pain among informal garment workers in the northeast of Thailand

This cross-sectional study investigated the prevalence of work-related shoulder pain (SP) and risk factors associated with SP among 446 informal garment workers, mainly in small or home businesses in the northeast of Thailand. Data were collected by face-to-face interviews using a structured questionnaire and a survey form about the working environment. Risk factors for SP were indicated by multiple logistic regression analysis. The six month-prevalence of SP was 46.9%. The significant risk factors for SP included worked less than 10 years (ORadj = 1.5), no change of working posture each hour (ORadj = 2.0) and inappropriate seat width (ORadj = 3.0). It is concluded that the prevalence of SP is high in Thai garment workers and that work posture and workstation are contributing risk factors. In order to help reduce or prevent SP in this occupational group, it is proposed that ergonomics education and redesign of seats at workstations should be routinely implemented.

Shoulder Pain among High-Level Volleyball Players and Preseason Features

The main goal of this prospective study was to identify the most significant intrinsic risk factors for shoulder pain by measuring strength developed by shoulder rotators and by carrying out various morphostatic assessments. Sixty-six players (mean ± SD age = 24 ± 5 yr) were recruited from nine volleyball teams from the first and second divisions (34 men and 32 women) to participate in the study. Before the start of the volleyball season, all the participants completed a preseason questionnaire and underwent both a bilateral isokinetic evaluation of the shoulders and morphostatic measurements. During the subsequent 6 months of the competition period, the players reported through a weekly questionnaire any shoulder pain experienced. During the ongoing season, 23% (15 of 66 players) of the volleyball players experienced dominant shoulder pain. Interestingly, participants who reported a history of dominant shoulder pain were found to have nine times higher risk of suffering further pain in their dominant shoulder. The eccentric maximal strength developed by the internal and external rotators was found to represent a protective factor in the volleyball players (respective odds ratios = 0.946, P = 0.01 and 0.94, P = 0.05). No risk factors were found among the shoulder morphostatic measurements. In our study, the evaluation of shoulder rotator muscle strength through isokinetic assessment, especially eccentric mode, appeared to be the most contributing parameter to identify risk factors for shoulder pain. This evaluation should allow to better identify players at risk.

Shoulder Joint Loading and Posture During Medicine Cart Pushing Task

Excessive physical loads and awkward shoulder postures during pushing and pulling are risk factors for shoulder pain. Pushing a medicine cart is a major component of a work shift for nurses and medical assistants in hospitals and other health care facilities. A laboratory experiment was conducted to examine the effects of common factors (e.g., lane congestion, cart load stability, floor surface friction) on shoulder joint moment and shoulder elevation angle of participants during cart pushing. Participants pushed a medicine cart on straight tracks and turning around right-angle corners. Peak shoulder joint moments reached 25.1 Nm, 20.3 Nm, and 26.8 Nm for initial, transition, and turning phases of the pushing tasks, indicating that shoulder joint loading while pushing a medical cart is comparable to levels previously reported from heavy manual activities encountered in industry (e.g., garbage collection). Also, except for user experience, all other main study factors, including congestion level, cart load stability, location of transition strip, shoulder tendency, surface friction, and handedness, significantly influenced shoulder joint moment and shoulder elevation angle. The findings provide a better understanding of shoulder exposures associated with medicine cart operations and may be helpful in designing and optimizing the physical environment where medicine carts are used.

Shoulder Pain in Iranian Elite Athletes: The Prevalence and Risk Factors

ObjectiveShoulder sports injuries are relatively common in athletes who perform highly repetitive motions. The purposes of this study were to determine the prevalence of and risk factors for shoulder injuries and to analyze how individual and other sport characteristics contribute to the risk of shoulder injuries among 6 overhead sports, those being swimming, rowing, wrestling, basketball, volleyball, and handball. MethodsA cross-sectional study was carried out on 613 Iranian overhead sports athletes in different collegiate sport fields. Data were collected using different questionnaires. A structured questionnaire including demographics, sport characteristics, and also prevalence and risk factors of shoulder pain was used. Visual analogue scale and Disability of the Arm, Shoulder, and Hand questionnaires were used to determine the pain intensity and functional disability, respectively. ResultsPoint, last 6-month, last year, and lifetime prevalences of shoulder pain were 21.4%, 29%, 38.8%, and 41.6%, respectively. The highest point prevalence was related to the rowing athletes with 31.9% and the lowest for swimming athletes (12.3%). Sex, body mass index, sport level, days of practice per week, and satisfaction with income were found to be significantly correlated with the prevalence of shoulder pain (P < .05 in all instances). For those with shoulder pain, the mean pain intensity and functional disability were 53.8 mm and 15.46%, respectively. ConclusionsThe prevalence of shoulder pain in athletes with highly repetitive overhead motions seems to be high.

Shoulder pain in swimmers: A 12-month prospective cohort study of incidence and risk factors

ObjectiveTo investigate shoulder pain incidence rates and selected risk factors for shoulder pain in competitive swimmers. Design12-month prospective cohort study. SettingFive swimming clubs in Melbourne, Australia. Participants74 (37 M, 37 F) competitive swimmers ranging in age from 11 to 27 years and performing at least five swim sessions per week. Assessment of risk factorsSwimmers completed a baseline questionnaire regarding demographics, anthropometric features, swimming characteristics and training and injury history. Active shoulder internal (IR) and external rotation (ER) range of motion and passive joint laxity were measured. Main outcome measurementsShoulder pain was self-reported over 12 months with significant interfering shoulder pain (SIP) defined as pain interfering (causing cessation or modification) with training or competition, or progression in training. A significant shoulder injury (SSI) was any SIP episode lasting for at least 2 weeks. Results28/74 (38%) participants reported SIP while 17/74 (23%) reported SSI. Exposure-adjusted incidence rates were 0.3 injuries and 0.2 injuries per 1000 swim km for SIP and SSI, respectively. Swimmers with both high and low ER range were at 8.1 (1.5, 42.0) and 12.5 (2.5, 62.4) times greater risk of sustaining a subsequent SIP, respectively and 35.4 (2.8, 441.4) and 32.5 (2.7, 389.6) times greater risk of sustaining a SSI, respectively than those with mid-range ER. Similarly swimmers with a history of shoulder pain were 4.1 (95% CI: 1.3, 13.3) and 11.3 (95% CI: 2.6, 48. 4) times more likely to sustain a SIP and SSI, respectively. ConclusionShoulder pain is common in competitive swimmers. Preventative programs should be particularly directed at those swimmers identified as being at risk of shoulder pain.

Comparison of risk factors for shoulder pain and rotator cuff syndrome in the working population

To compare risk factors for shoulder pain without and with rotator cuff syndrome (RCS). A total of 3,710 workers of a French region were randomly included in the cross-sectional study between 2002 and 2005. Personal and occupational risk factors were assessed during a physical examination and by a self-administered questionnaire. Multinomial logistic modeling was used for the following outcomes: no shoulder pain and no RCS (reference), shoulder pain without RCS (called "shoulder pain") and RCS, separately for men and women. The prevalence rates of "shoulder pain" for men and women were 28.0% and 31.1%, respectively, and the prevalence rates of RCS were 6.6% and 8.5%, respectively. In men, "shoulder pain" and RCS were associated with age, high-perceived physical exertion, and arm abduction. Automatic work pace and low supervisor support were associated with "shoulder pain," and high psychological demand and low skill discretion with RCS. In women, "shoulder pain" and RCS were associated with age, repetitiveness of tasks, and low supervisor support. High perceived physical exertion and exposure to cold temperatures were associated with "shoulder pain." Age was more strongly associated with RCS than with shoulder pain without RCS for both genders. Biomechanical and psychosocial factors were associated with "shoulder pain" and RCS and differed between genders.

Risk Factors for Volleyball-Related Shoulder Pain and Dysfunction

To identify risk factors for volleyball-related shoulder pain and dysfunction. Cross-sectional, observational. National championship sporting event. Competitors at the 2006 National Intramural & Recreational Sports Association Collegiate Club Volleyball Championship competition were invited to volunteer for the study. A total of 422 athletes returned questionnaires, of whom 276 also underwent a structured physical examination. Study participants provided information on any history of volleyball-related shoulder pain or dysfunction. The simple shoulder test (SST) and a visual analog scale permitted subjects to quantify the extent of their perceived functional limitation. Subjects also were invited to undergo a physical examination in which dynamic scapular positioning, glenohumeral range of motion, shoulder girdle strength, and core stability were assessed. Standard statistical methods of comparison and tests of association were used to identify risk factors for shoulder pain among participating volleyball athletes. Approximately 60% of participants reported a history of shoulder problems. Attackers and "jump" servers were more likely to have shoulder problems than setters, defensive specialists, and "float" servers. Nearly half of the athletes who reported shoulder problems perceived some associated functional limitation, with female athletes providing lower SST scores than male athletes (9.0 versus 10.1, P = .001). Athletes reporting shoulder pain and dysfunction were more likely to have SICK scapula scores of 3 or greater (P = .010). Participants who demonstrated core instability also had greater SICK scapula scores (3.9 versus 2.9, P = .038), and were more likely to report a history of shoulder problems (chi2 = 8.83, P = .032). Although the authors observed a significant mean left-right difference of 8.9 degrees in available glenohumeral internal rotation among participating athletes, this deficit was not associated with shoulder problems. However, there was an association between asymmetric coracoid tightness /pectoral shortening and shoulder pain (P = .030), as well as for restricted shoulder flexion in the sagittal plane and shoulder problems (P = .015). Although most risk factors for volleyball-related shoulder problems are similar to those identified for other overhead sports, there appear to be additional volleyball-specific risk factors that may reflect the biomechanical demands of the sport. An understanding of modifiable risk factors is critical to providing optimal care for overuse injuries and may facilitate future efforts to prevent shoulder problems among volleyball athletes.

Reduced active control and passive range at the shoulder increase risk of shoulder pain during inpatient rehabilitation post-stroke: an observational study

What factors at admission are associated with shoulder pain during stroke rehabilitation? Retrospective audit of medical histories and logistic regression. 94 people with primary diagnosis of stroke attending inpatient rehabilitation. Predictors were a battery of impairments, stroke-related factors, and patient characteristics. The outcome of interest was shoulder pain. Shoulder pain was present in 23% of patients at admission, and in a total of 35% of patients during inpatient stay. Patients with pain differed significantly (p = 0.04) from those without pain for several factors including age, longer time until rehabilitation admission, impaired movement of the arm (Motor Assessment Scale items), reduced passive range of movement, subluxation, and altered tone and sensation. No differences were found for many factors including neglect, cognitive impairment, side of stroke, and body weight. Logistic regression exploring the association between four predictors (shoulder range, Motor Assessment Scale items, subluxation, and altered sensation) and shoulder pain (outcome of interest) found that shoulder pain was reliably associated with two factors: reduced passive shoulder range (OR 14%, 95% CI 3 to 64), and Motor Assessment Scale Upper Arm item score (OR 64%, 95% CI 43 to 96). The model accurately classified 85% of patients. Shoulder pain is common and occurs early after stroke. Reduced active control and passive range at the shoulder appear to be risk factors for shoulder pain during inpatient rehabilitation post-stroke.

Risk and prognostic factors for non-specific musculoskeletal pain: A synthesis of evidence from systematic reviews classified into ICF dimensions

A wide variety of risk factors for the occurrence and prognostic factors for persistence of non-specific musculoskeletal pain (MSP) are mentioned in the literature. A systematic review of all these factors is not available. Thus a systematic review was conducted to evaluate MSP risk factors and prognostic factors, classified according to the dimensions of the International Classification of Functioning, Disability and Health. Candidate systematic reviews were identified in electronic medical journal databases, including the articles published between January 2000 and January 2008 that employed longitudinal cohort designs. The GRADE Working Group’s criteria for assessing the overall level of evidence were used to evaluate the reviews. Nine systematic reviews were included, addressing a total of 67 factors. High evidence supported increased mobility of the lumbar spine and poor job satisfaction as risk factors for low back pain. There was also high evidence for intense pain during the onset of shoulder and neck pain and being middle aged as risk factors for shoulder pain. High evidence was also found for several factors that were not prognostic factors. For whiplash-associated disorders these factors were older age, being female, having angular deformity of the neck, and having an acute psychological response. Similarly, for persistence of low back pain, high evidence was found for having fear-avoidance beliefs and meagre social support at work. For low back pain, high evidence was found for meagre social support and poor job content at work as not being risk factors.

Glenohumeral subluxation in hemiplegia: An overview

This review summarizes the recent advances in glenohumeral subluxation (GHS) in hemiplegic patients and analyzes the reliability and validity of clinical evaluation and the effectiveness of different treatment approaches. GHS, a common complication of stroke, can be considered an important risk factor for shoulder pain and other problems. GHS is a complex phenomenon, and its pathomechanics are not yet fully understood. Radiographic measurements are considered the best method of quantifying GHS. Clinical evaluation can be useful as screening assessment. Functional electrical stimulation and strapping are effective in an acute stage of hemiplegia; some types of slings have been shown to be effective and may be used together with other strategies.