Assessment of ultrasonography as a diagnostic tool in shoulder pain and alterations in glenohumeral range of motion in tennis players

Introduction
Shoulder pain and alterations in the range of motion are common disorders in tennis players. However, the relation between shoulder structures and these conditions is unknown.

Aim
To evaluate whether, using ultrasonography, one can identify tennis players with shoulder pain and those having specific changes of the range of rotation of the glenohumeral joint.

Material and methods
A total of 66 subjects were assessed through examination of the range of rotation of the glenohumeral joint and ultrasonography.

Results
The study group consisted of 37 people with shoulder pain (24.2 ±8.6 years) and the control group included 29 subjects without shoulder pain (21.9 ±10.8 years). The prevalence of pathologies of the supraspinatus (SSP), infraspinatus (ISP) or subscapularis (SSC) was significantly higher in the study group than in the control group (p = 0.044) but solely for the combined pathologies. The incidence rate of pathological shoulder changes (the SSP, ISP, SSC and the subacromial bursa) was not correlated with the ranges of rotations or intensity of pain. Glenohumeral internal rotation deficit (GIRD), total rotational motion (TROM) deficit and external rotation deficiency (ERD) were independent of pathological shoulder changes, except the significantly higher prevalence of SSP pathologies among subjects with ERD.

Conclusions
Ultrasonography could be helpful in identifying tennis players with painful shoulder having rotator cuff pathologies. However, the ability of the method to identify players having specific changes of the range of rotation of the glenohumeral joint is limited, with the exception of tennis players with ERD having SSP pathologies.