Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
Fundacion Gotze, Madrid, Spain.
Braz J Phys Ther. 2020 Jul-Aug;24(4):333-341. doi: 10.1016/j.bjpt.2019.05.008. Epub 2019 Jul 30.
Shoulder injuries are common in individuals who use wheelchairs.
This 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.
Eighteen 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.
Wheelchair 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).
The 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.
在使用轮椅的人群中,肩部损伤较为常见。
本研究旨在调查患有肩部疼痛的精英轮椅篮球运动员、无肩部疼痛的精英轮椅篮球运动员和无症状的健全精英篮球运动员颈肩部肌肉中机械性疼痛过敏和触发点的存在情况。
招募了 18 名患有肩部疼痛的男性轮椅篮球运动员、22 名无肩部疼痛的运动员和 20 名健全的精英男性篮球运动员。评估了 C5-C6 关节突关节、三角肌和第二掌骨处的压痛阈值。还检查了斜方肌上束、冈上肌、小圆肌、冈下肌、大圆肌、背阔肌、肩胛下肌、胸小肌、胸大肌和三角肌的触发点。
患有肩部疼痛的轮椅篮球运动员 C5-C6 关节突关节和第二掌骨处的压痛阈值低于无疼痛的精英轮椅篮球运动员(组间差异:1.1,95%CI 0.4,1.8 和 1.8,95%CI 0.8,2.8),也低于无疼痛的健全篮球运动员(组间差异:0.8,95%CI 0.4,1.2;1.6,95%CI 0.8,2.4)。患有单侧肩部疼痛的轮椅篮球运动员的肌筋膜触发点平均数为 4.8±2.7(2±1 个活跃,2.9±2.2 个潜伏)。无肩部疼痛的轮椅篮球运动员和健全篮球运动员的潜伏触发点数量相似(分别为 2.4±2.0 和 2.4±1.8)。患有肩部疼痛的轮椅篮球运动员的活跃肌筋膜触发点数量高于无疼痛(无论是否使用轮椅)的运动员,但所有组的潜伏触发点数量相似(P<0.05)。
报告的机械性疼痛过敏表明,活跃的触发点可能在男性精英轮椅篮球运动员肩部疼痛的发展中起作用。