Sexual Activities as Risk Factors of Rotator Cuff Lesions: A Prospective Cohort Study

Abstract

The aim of this study was to analyze the occurrence of rotator cuff impingement due to reduction of subacromial space height during complex shoulder motion to determine safety of sexual activities. The hypothesis was that such activities could be deleterious if not performed with precaution. To use a patient-specific 3D measurement technique coupling medical imaging and optical motion capture to evaluate the safety of various sexual positions according to subacromial compression. Descriptive laboratory study. A volunteer couple underwent Magnetic Resonance Imaging (MRI) and motion capture of their shoulders. Five common active and passive sexual positions were evaluated. Significant differences in subacromial space height were observed between the different performed actions. All active sexual positions requiring important pressure on the hands or elbows (e.g., scorpio) or weight lifting (e.g., superman) caused subacromial impingement. No subacromial impingement was however observed during passive sexual activities (e.g., basset hound). This study indicates that some sexual positions could potentially place the rotator cuff at risk. Such high-tech investigation shows promise in the areas of cause, intervention and education. The present findings may assist health professionals in providing them with preventive measures and is highly relevant for decision-making regarding health promoting initiatives.

What Are the Physical Demands of Sexual Intercourse? A Systematic Review of the Literature

“…Lastly, there was one study that collected data on the kinematic demands on the rotator cuff, based on the height of the subacromial space (Lädermann et al, 2018 ). This study found that the subacromial space height was lower for the watering can (~ 6.10 mm) and basset hound (~ 6.20 mm) positions compared to the scorpion (~ 0.91 mm), missionary (~ 1.27 mm), or superman (~ 1.76 mm) positions (Lädermann et al, 2018 ).…”

“…In this regard, a recent study concluded that intercourse positions such as the scorpion, missionary, or superman may cause rotator cuff degeneration because of friction on the undersurface of the acromion (Lädermann et al, 2018 ). This is due to the reduced or minimal subacromial space height (Lädermann et al, 2018 ). However, it is not only subacromial impingement that might lead to rotator cuff degeneration but also the scapular morphology (Moor et al, 2014 ).…”

“…Specifically, the VO 2 is a variable representing the ability of the respiratory and circulatory systems to supply oxygen during any sustained physical activity (Hawkins et al, 2007 ). In contrast, the kinematic variables, which were selected in line with previous studies (Charbonnier et al, 2014 ; Lädermann et al, 2018 ; Sidorkewicz & McGill, 2014 , 2015 ), included those related to the movement patterns (e.g., range of motion in degrees or penetration cycle speed) used during sexual intercourse. Once the data were extracted, a systematic qualitative review and interpretation of results was carried out.…”

“…Lastly, there was one study that collected data on the kinematic demands on the rotator cuff, based on the height of the subacromial space (Lädermann et al, 2018). This study found that the subacromial space height was lower for the 2018) Scorpion: the female stays in a quadruped position and the male, who is in a front plank position, enters from behind Missionary: the female lies on her back with the knees flexed and the male on top with his face opposite hers Superman: the male holds the female face down.…”

“…Also, the female's knees are brought up to his side and her trunk is leant forward Position 11: the male lies on his back with the knees slightly flexed and the female on top with her face opposite his. Also, the female's knees are brought up to his side and her trunk is perpendicular to the male Position 12: the male sits on a chair while he enters the female (who is sitting on him) from behind watering can (~ 6.10 mm) and basset hound (~ 6.20 mm) positions compared to the scorpion (~ 0.91 mm), missionary (~ 1.27 mm), or superman (~ 1.76 mm) positions (Lädermann et al, 2018).…”