Bimonthly, Established in 1959
Open access journal

Exploring Tendon Degeneration and Risk Factors in Wheelchair Users with SCI: A Focus on Shoulder Pain and Propulsion-Related Injuries

Wheelchair users with spinal cord injuries (SCI) often face increased risk of shoulder pain due to repetitive strain and overuse. This is particularly concerning as shoulder pain can significantly affect mobility, participation, and overall quality of life. A notable study found that up to 43% of wheelchair users with SCI experience shoulder pain, with a higher prevalence observed among women. This pain is commonly attributed to musculoskeletal issues such as sub-acromial pain syndrome, often diagnosed through ultrasound showing issues like supraspinatus tendinopathy.

The mechanics of tendon injury in these individuals involve a complex interplay of collagen protein synthesis and degeneration, leading to stiffer, maladapted tendons prone to further injury and rupture. This degradation is visually apparent in ultrasound images as disorganized collagen fibers and increased fluid within the tendons. Factors such as age, body weight, and duration of wheelchair use exacerbate these risks, highlighting the multifactorial nature of tendinopathy.

The study in discussion aims to identify changes in tendon structure post-fatigue from wheelchair propulsion and to associate these changes with various risk factors for shoulder pain, such as fatigue susceptibility, gender, and acromio-humeral distance. It hypothesizes that repetitive propulsion leads to significant changes in tendon appearance, particularly in those who are female, exhibit fatigue, or have used a wheelchair for extended periods. This research is crucial for developing targeted training strategies to enhance tendon resilience and reduce injury risk in this vulnerable population.

References

Changes in supraspinatus and biceps tendon thickness: influence of fatiguing propulsion in wheelchair users with spinal cord injury