BLAUWET, C. A., J. CHAKRAVERTY, W. DERMAN, G. IDRISOVA, P. MARTIN, S. C. MILLER, D. MORRISSEY, and N. WEBBORN. Shoulder Pain, Function, and Ultrasound-Determined Structure in Elite Wheelchair-Using Para Athletes: An Observational Study. Med. Sci. Sports Exerc., Vol. 54, No. 6, pp. 896-904, 2022. Purpose: This study aimed to determine the relationship between shoulder pain, physical examination, and tissue pathology in manual wheelchair users competing in elite sport. Methods: Eighty elite para athletes who used a manual wheelchair for daily mobility were recruited from international track (n = 40), field (n = 19), and powerlifting (n = 21) competitions. Athletes were surveyed regarding shoulder pain history and symptoms (Wheelchair User’s Shoulder Pain Index (WUSPI)), whereas independent blind observersmeasured signs (Physical Examination of the Shoulder Scale (PESS)) and tissue pathology (Ultrasound Shoulder Pathology Rating Scale (USPRS)). Relationships between measures for the total cohort and for subgroups defined by sporting discipline were calculated. Results: A large proportion of athletes reported a history of upper limb pain (39% dominant and 35% nondominant). For the total cohort, WUSPI score was 22.3 ± 26.9, PESS score was 7.4 ± 6.7, and USPRS score was 5.2 ± 4.0. There were no USPRS score differences between athlete subgroups; however, track athletes had lowerWUSPI and PESS scores, especially compared with field athletes. The first principal component explainedmost of the variance in theWUSPI and PESS,whichwere strongly correlated (r = 0.71), and the second orthogonal component explained theUSPRS, which did not correlate with either the PESS (r = 0.21) orWUSPI (r = 0.20). Subgroup analysis showed that track athletes had lower symptom scores for a given physical examination score.Conclusions: Elite para athleteswho usemanualwheelchairs for daily mobility have a high prevalence of shoulder symptoms, positive signs on physical examination, and ultrasound-determined tissue pathology. Ultrasound-determined tissue pathology does not correlate with symptoms or signs. This information can help to guide clinicians in managing shoulder problems in this athlete population at high risk of injury. © 2022 by the American College of Sports Medicine.
