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Clinical and ultrasonographic correlation between scapular dyskinesia and subacromial space measurement among junior elite tennis players
  1. R T Silva1,2,3,
  2. L G Hartmann4,
  3. C F de Souza Laurino2,
  4. J P Rocha Biló5
  1. 1Orthopedics and Sports Medicine, Sao Paulo, Brazil
  2. 2Orthopedic Sports Medicine Research Center, Sao Paulo, Brazil
  3. 3Brazilian Tennis Confederation, Sao Paulo, Brazil
  4. 4Musculoskeletal Ultrasound Division, Department of Radiology, Federal University of Sao Paulo, Sao Paulo, Brazil
  5. 5Federal University of Sao Paulo Medical College, Sao Paulo, Brazil
  1. Correspondence to Dr Rogerio Teixeira Silva, Orthopedics and Sports Medicine, Rua Botucatu 591, 18 Andar, Sao Paulo, CEP 04023-062, Brazil; rogerio{at}


Objectives In this study, the hypothesis that tennis players with scapular dyskinesia present a smaller subacromial space than non-athletes was investigated. Additionally, the correlation between the size of the subacromial space and abnormalities in scapular movement during arm abduction was studied.

Design Cross-sectional study.

Participants A total of 53 elite tennis players and 20 control participants were enrolled in the study. Participation was restricted to elite-level, junior tennis players who had no current shoulder pain or history of shoulder injuries.

Intervention Each individual was examined for scapular dyskinesia by a single physician and by ultrasound, with the results analysed in a blind fashion by a single radiologist.

Results 43.4% of the tennis players and 20% of control participants presented with scapular dyskinesia. Of the 106 shoulders evaluated, 39.6% of tennis players and 10% of control participants presented with scapular dyskinesia in the clinical examination (p = 0.005). Ultrasonographic measurements demonstrated that tennis players presented statistically smaller subacromial spaces compared with control participants (p<0.001). A decrease in the subacromial space was observed in tennis players when the shoulder was raised from 0° to 60° of abduction; however, dyskinesia-afflicted athletes demonstrated a significantly greater decrease following this movement (19.3 vs 13.8 mm, p = 0.002).

Conclusions The results of this study demonstrated that tennis players with scapular dyskinesia present a smaller subacromial space than control participants. Furthermore, when the shoulder was analysed dynamically, moving from neutral abduction to 60° of elevation, the tennis players with scapular dyskinesia presented a greater reduction in the subacromial space compared with unaffected athletes.

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  • Competing interests None.

  • Ethics approval The study was approved by the ethics committee of our research division, which is a part of the national research ethics system of Brazil.

  • Patient consent Obtained.