Glenohumeral Rotational Deficit and Suprascapular Neuropathy in the Hitting Shoulder in Male Collegiate Volleyball Players

Abstract

Repetitive overhead movements stress the dominant shoulder of volleyball players, potentially causing glenohumeral internal rotation deficit (GIRD) and suprascapular neuropathy. The aim of this study was to determine the prevalence of pathological GIRD and suprascapular neuropathy in male collegiate volleyball players. Methods: We evaluated 22 male collegiate volleyball players and compared the range of motion, the isometric shoulder strength, the thickness of the infraspinatus (ISP) muscle, and the latency and amplitude of the suprascapular nerve [in a nerve conduction study (NCS)] between the hitting and contralateral shoulders. Correlations between the physical findings and each parameter were also determined. Results: The internal rotation angle of the hitting shoulder (55.1±8.7°) was significantly less than that of the contralateral shoulder (64.5±10.2°) (P<0.001); pathological GIRD (≥20°) was found in four players (18.2%). Three players (13.6%) showed abnormal electrophysiological findings of the suprascapular nerve on the ISP muscle in the hitting shoulder. The external-to-internal rotation (ER/IR) torque ratio in the hitting shoulder (99±18%) was significantly lower than that in the contralateral shoulder (106±12%) (P=0.04); no significant differences were observed in ISP muscle thickness or NCS data between the hitting and contralateral shoulders. Conclusion: The prevalence of pathological GIRD in male collegiate volleyball players was consistent with that of previous studies. Meanwhile, the prevalence of suprascapular neuropathy was less than that previously reported in high-level volleyball players. Preventive posterior rotator cuff strengthening programs are recommended to correct imbalances between ER and IR in the hitting shoulder, thereby decreasing the risk of shoulder injury.

A Tale of Two Suprascapular Neuropathy Presentations: A Case Report

“…Treatment includes anti-inflammatory medications, activity modification, and physical therapy [ 1 , 6 , 9 ]. Many reports describe traction injury to SSN neuropathy in various overhead athletics including volleyball, golf, basketball, tennis, weight-lifting, and swimming [ 1 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. SSN neuropathy is more common in athletes playing volleyball with a prevalence of infraspinatus, supraspinatus muscle atrophy, and weakness in up to 20–45% of volleyball players compared to 12–33% across all athletes [ 12 , 17 , 21 ], The exact mechanism of injury is contentious.…”

“…SSN neuropathy is more common in athletes playing volleyball with a prevalence of infraspinatus, supraspinatus muscle atrophy, and weakness in up to 20–45% of volleyball players compared to 12–33% across all athletes [ 12 , 17 , 21 ], The exact mechanism of injury is contentious. Some authors describe compression of the SSN during terminal shoulder external rotation and abduction, or cocking phase and subsequent follow through [ 16 ]. Using EMG and nerve conduction study of 35 professional beach volleyball players, Lajtai et al described infraspinatus atrophy in 34% of participants and significant external rotation and elevation strength deficits in 90% and 93% of their cohort’s hitting shoulder, respectively [ 13 ].…”

Effectiveness of Capsular Stretching and Strengthening of Shoulder on Back Pain among Recreational Volleyball Players

“…The parameters taken into consideration for GIRD are humeral retroversion and stiffness in the rotator cuff and posterior capsule. 3 A loss of more than 20% in the internal rotation range when compared to the contralateral shoulder is defined as GIRD. 4 Back pain is the most common problem faced by both younger and older people affecting between 54% and 90% of the population.…”