High Prevalence of Nontraumatic Shoulder Pain in a Regional Sample of Female High School Volleyball Athletes

Abstract

Background:Shoulder pain is becoming increasingly problematic in young players as volleyball gains popularity. Associations between repetitive motion and pain and overuse injury have been observed in other overhand sports (most notably baseball). Studies of adult athletes suggest that there is a shoulder pain and overuse problem present in volleyball players, but minimal research has been done to establish rates and causes in juvenile participants.Purpose:To establish rates of shoulder pain, regardless of whether it resulted in a loss of playing time, in female high school volleyball players. A secondary goal was to determine whether high repetition volumes correlated with an increased likelihood of experiencing pain.Study Design:Descriptive epidemiology study.Methods:A self-report survey focusing on the prevalence of pain not associated with a traumatic event in female high school youth volleyball players was developed. Survey questions were formulated by certified athletic trainers, experienced volleyball coaches, and biomechanics experts. Surveys were received from 175 healthy, active high school volleyball players in Iowa, South Dakota, and Minnesota.Results:Forty percent (70/175) of active high school volleyball players remembered experiencing shoulder pain not related to traumatic injury, but only 33% (23/70) reported taking time off to recover from the pain. Based on these self-reported data, activities associated with significantly increased risk of nontraumatic shoulder pain included number of years playing competitive volleyball (P = .01) and lifting weights out of season (P = .001). Players who reported multiple risk factors were more likely to experience nontraumatic shoulder pain.Conclusion:When using time off for recovery as the primary injury criterion, we found that the incidence of shoulder pain is more than twice as high as the incidence of injury reported by previous studies. Findings also indicated that the incidence of shoulder pain may be correlated with volume of previous volleyball experience.

Incidence, prevalence, and risk factors for elbow and shoulder overuse injuries in youth athletes: A systematic review

“…Twenty‐eight articles focused on pain of the elbow and/or shoulder related to overhead sports, published between 1965 and 2017. The studies were conducted in the USA, Japan, Norway, Brazil, Taiwan, and the UK . Sixteen of the articles that reported pain as outcome were cross‐sectional studies, nine articles collected data prospectively, and two studies had a retrospective design …”

“…Twenty‐five of the 28 studies that reported pain as outcome focussed on youth baseball players . The three other studies described pain rates for handball, volleyball or handball, volleyball, and basketball . Most studies used a binary scale to evaluate the presence of elbow or shoulder.…”

Thoracic spine mobility, an essential link in upper limb kinetic chains in athletes: A systematic review

“…Findings from three studies (n = 82, n = 68 females) report 4‐8° thoracic extension occurring during arm elevation with studies reporting variable ranges and degrees of other thoracic movement. Findings are relevant to athletes engaged in overhead sporting activities where deficiencies in thoracic extension may place more stress on other components of the kinetic chain resulting in pain, altered performance, and impact on an athlete's ability to train and compete . Whilst a recent review found inconclusive evidence of a relationship between static thoracic posture and shoulder complaints, functional kinetic chains are dynamic, requiring a variable mix of movement, motor control, and strength across the component parts, including the thoracic spine to enable performance of skilled functional movement.…”

“…Findings are relevant to athletes engaged in overhead sporting activities 1,3 where deficiencies in thoracic extension may place more stress on other components of the kinetic chain resulting in pain, altered performance, and impact on an athlete's ability to train and compete. 1 Whilst a recent review found inconclusive evidence of a relationship between static thoracic posture and shoulder complaints, 15 functional kinetic chains are dynamic, requiring a variable mix of movement, motor control, and strength across the component parts, including the thoracic spine to enable performance of skilled functional Upper thoracic Crosbie et al 38 Extension 2 [1,3] Lateral flexion (Ipsilateral) 3 [2,3] Rotation (Ipsilateral) 7 [5,9] Lower thoracic Crosbie et al 38 Extension 6 [4,8] Lateral flexion (Contralateral) 3 [2,4] Rotation Rotation (Ipsilateral) 7 [5,9] Lower thoracic Crosbie et al 38 Extension 2 [1,2] Lateral flexion (Contralateral) 7 [5,8] 38 Stewart et al 37 Extension…”

“…Sports‐related musculoskeletal complaints involving the shoulder are common, and those that place heavy functional demands on the shoulder are complex. Reported pain or injury prevalence levels are consistently high across a number of sports: elite handball 44%‐75%, baseball pitchers, 46%‐57% softball 50.2%, volleyball 40%, and tennis 25%‐47.7% . Complaints are not however limited to arm‐dominant sports with comparable levels of 47% seen in football and 54% in swimming .…”