2017 ISAKOS Biennial Congress ePoster #2118

 

Frequency of Suprascapular Nerve Entrapement in Elite Tennis Players

Emilio Lopez-Vidriero, MD, PhD, Seville, Andalusia SPAIN
Rosa Lopez-Vidriero, MD, Madrid, Madrid SPAIN
Antonio Maldonado, MD, Seville SPAIN
Alvaro Arriaza Cantos, MD, Madrid SPAIN
Gonzalo Couceiro, MD, La Coruña, La Coruña SPAIN
Rafael Arriaza-Loureda, MD, PhD, Perillo, Oleiros, La Coruña SPAIN

ISMEC Seville / Instituto Médico Arriaza La Coruña. , Seville / La Coruña, SPAIN

FDA Status Not Applicable

Summary

103 elite tennis players were studied during 3 international tennis championships. In 40 of them, noninvasive electroneurogram was performed. Three of them presented a positive electroneurogram and electromyogram, showing SSN entraped either at the suprascapular (2 cases) or infraglenoid notch (1 case). Thus, 7.5% of the tennis players examined showed a SSN entrapement.

Abstract

Background

Suprascapular nerve entrapment has been reported to cause shoulder pain and disability in elite swimmers at the suprascapular notch and volleyball players at the spinoglenoid notch. Shoulder pain is the most common cause of being off competition or training in elite tennis players.
There are no studies showing the prevalence of suprascapular nerve pathology in both genders of elite tennis players. Neither the location and intensity of entrapment

Purpose

The purpose of this study was to evaluate the presence of suprascapular nerve entrapment, its location and severity in elite tennis players by means of neurophysiological study. Also study its laterality and associated risk factors

Methods

103 elite tennis players were studied during 3 international tennis championships in 2013-2014. N=103. 86 tennis players were males and 48 females. 27 were left handed. Mean age was 21,7+/-4,9. Mean tennis hours played a week 19,4+/-4,9. Their ranking range was ATP 56-1000 and WTA 102-1000. Informed consent was obtained.
-Physical examination was performed by an orthopaedic surgeon fellowship trained in sports medicine in all tennis players focusing in posterior shoulder atrophy in both supra and infraspinatus fossae atrophy.
- Electrophysiologic exam was performed by a neurophysiologist subspecialized in sports medicine. -Noninvasive electroneurogram was performed to all the patients who consented (n=40).
-If positive and invasive electromyogram to confirm, diagnose the location and severity of entrapment was performed.
-If entrapment was confirmed an MRI was performed to look for no structural alterations like ganglions or SLAP lesions by an MSK MRI radiologist.
-Associated risk factors were searched.

The statistical analysis was performed with the SPSS software package. For linear correlations Spearman rank correlation was used. For bivariate analysis Mann-Whitney test was used.

Results

-Physical inspection: 5,8% (6/103) presented posterior shoulder atrophy.
-ENG-EMG: 7,5% (3/40) presented a positive electroneurogram and electromyogram.
-Location and intensity of entrapment: 66% (2/3) presented a severe entrapment at the suprascapular notch. 33% (1/3) presented a moderate entrapment at the spinoglenoid notch. All of them in the dominant arm.
-MRI: all of them were negative for any structural pathology.
- Associated Risk factors: Higher number of tennis hours played per week are related to higher risk of suprascapular neuropathy, as well as increased age,

Conclusion

Suprascapular pathology is present in elite active tennis players and it is of moderate and severe intensity.
The compression can be located at the suprascapular or spinoglenoid notch.
The risk increases according to the number of tennis hours played per week and the age.
It is important to suspect this pathology and inspect the posterior part of the shoulder of the tennis players.
In our opinion, the entrapment seems to be dynamic in relation to the shoulder biomechanical alterations associated to tennis players.