2015 ISAKOS Biennial Congress ePoster #2116
The Swimmer´s Shoulder: Suprascapular Neuropathy as a Cause and Results After Arthroscopic Treatment
Emilio Lopez-Vidriero, MD, PhD, Seville, Andalusia SPAIN
Rafael Arriaza-Loureda, MD, PhD, Perillo, Oleiros, La Coruña SPAIN
Rosa Lopez-Vidriero, MD, Madrid, Madrid SPAIN
Alvaro Arriaza Cantos, MD, Madrid SPAIN
Julian Ballesteros, MD, Downey, CA UNITED STATES
ISMEC SEVILLA AND ARRIAZA ASSOCIATES, SEVILLA AND CORUÑA, SEVILLA CORUÑA, SPAIN
FDA Status Not Applicable
Summary: Pathology of the suprascapular nerve (SSN) has not been before included in the differential diagnosis of the swimmer´s shoulder syndrome. Arthroscopy is a useful tool both to confirm diagnosis and treat entrapment and neuropathy of the suprascapular nerve at the suprascapular notch in competitive swimmers. Recognizing this pathology and treating it may be a key factor in the return to competition
Swimmer´s shoulder is a syndrome including debilitating pathologies that impede the athletes to maintain their competing level of performance.
Suprascapular nerve (SSN) entrapment may cause swimmer´s shoulder. Arthroscopic surgical release and SSN neurolysis will allow elite swimmers with shoulder pain to return to their pre-injury level of competition.
Study Design: Case series. Level of evidence IV
From 2008 to 2012, five elite swimmers complaining of shoulder pain were diagnosed with SSN pathology by means of clinical suspicion and EMG. The mean age was 18.6+/-4 years. 3 females and 2 males were affected; 4 of 5 cases involved right shoulders. The mean duration of symptoms until diagnosis was 13+/-7 months. 4 of the swimmers underwent arthroscopic SSN release by 2 different surgeons with the same technique: resection of transverse ligament at the suprascapular notch and neurolysis of the suprascapular nerve. The fifth swimmer decided to stop competing and rejected surgery.
The mean follow up was 18.5 +/-5 months.
The main outcome variable was km swam per week (km/w) and return to previous level of competition. Other variables of the study were the UCLA, quick DASH and the sport specific qDASH scores, the VAS, measured strength and the presence of atrophy.
The statistical analysis was performed with the SPSS software package. For qualitative variables the Student t test was used for those paired variables which followed a gaussian behaviour. For those which did not, the Wilcoxon test was used.
In case of qualitative variables, the Mc Nemar test was applied. Statistical significance was set at 0.05.
km/w improved from 33+/-10 preoperatively to 48.7+/-10 postoperatively (p<0.05). All 4 operated swimmers returned to pre-injury level of competition in 7 +/-1 months. UCLA score preoperatively was 22.6+/-4 and postoperatively was 34+/-1 (p<0.05). The preoperative qDASH was 22.7+/-7 and postoperatively was 1.1+/-1(p<0.05). The sport specific qDASH preoperatively was 72.5+/-3 and postoperatively was 2+/-3(p<0.05). VAS preoperative was 6+/-1 and postoperatively was 0.25(p<0.05). Manual strength improved following surgery from a rating of 4/5 to 5/5. None had atrophy at final follow up.
Pathology of the suprascapular nerve (SSN) has not been before included in the differential diagnosis of the swimmer´s shoulder syndrome.
Arthroscopy is a useful tool both to confirm diagnosis and treat entrapment and neuropathy of the suprascapular nerve at the suprascapular notch in competitive swimmers.
Recognizing this pathology and treating it may be a key factor in the return to compete of elite swimmers.