Tennis players often suffer from shoulder pain due to the repetitive high-loaded overhead movements during serving, and subacromial pain syndrome is one of the main types of shoulder pain. Previous shoulder injury has been identified as one of the risk factors for shoulder overuse injuries in overhead sports. No research has explored differences in trunk kinematics and shoulder muscle activities among tennis players with and without subacromial pain syndrome or a history of shoulder pain. Furthermore, limited studies have examined shoulder kinematics during tennis serve and musculoskeletal characteristics in tennis players with subacromial pain syndrome or a history of shoulder pain. Therefore, this study aims to investigate shoulder and trunk kinematics and shoulder muscle activity during the tennis serve and musculoskeletal characteristics in tennis players with subacromial pain syndrome or a history of shoulder pain. This study will recruit sixty tennis players with subacromial pain syndrome, a history of shoulder pain, and healthy players. The electromagnetic tracking system will be applied to collect shoulder and trunk kinematics during the tennis serve, and surface electromyography will be simultaneously used for recording shoulder muscle activities. Moreover, we will collect shoulder and trunk rotational joint range of motion, isometric strength and rate of force development of shoulder internal and external rotation, scapulothoracic and glenohumeral joint control capability, upper quarter Y-balance test performance, and posterior shoulder endurance. This study will compare the difference of these measures in tennis players with subacromial pain syndrome or a history of shoulder pain to healthy players.
Amateur tennis players
National Tennis Rating Program (NTRP) should level ≥ 3.5
Training experience: ≥ 3 years, current or former school team players
Training volume: ≥ 4 hours/week
Any current musculoskeletal injuries preventing maximum skill execution at the time of testing
Previously had any form of surgery or trauma
Patient-reported pain that will inhibit participation in this study
Tennis players in Taiwan
Case-control
Cross-sectional
Not listed
Degree of the glenohumeral and scapulothoracic joint during serving
The kinematics is assessed using an electromagnetic motion tracking system (VIPERTM, Polhemus, USA) and IMU (Inertial Measurement Unit) systems (Noraxon USA, Scottsdale, AZ, USA) to collect the glenohumeral elevation, horizontal abduction/adduction, internal/external rotation, scapulothoracic retraction/protraction, upward/downward rotation, anterior/posterior tilt, and trunk rotation, sidebending, flexion/extension during tennis serve. During the test, participants performed 5 flat serves, with 60 seconds of rest between each trial. Data were analyzed at the end of the arm cocking (maximal shoulder horizontal abduction), at ball-contact (peak of acceleration or perturbation in IMU), and at the end of the arm deceleration (maximal shoulder horizontal adduction). Data will report as mean values for each trial. (unit of measure: degree, °)
Amplitude of the activation of glenohumeral and periscapular muscles
The muscle activation amplitude of the upper trapezius, lower trapezius, serratus anterior, latissimus dorsi, pectoralis major, biceps brachii, and triceps brachii would be recorded during tennis serve. During the test, participants performed 5 serves, with 60 seconds of rest between each trial. Data were collected in the arm cocking phase (from shoulder elevation over 5 standard deviation form resting to the shoulder maximal horizontal abduction) and the acceleration phase (from maximal shoulder horizontal abduction to the ball-contact), and the deceleration phase (from ball-contact to maximal horizontal adduction). The data will be reported as mean values for each trial. (unit of measure: percentage, %)
Shoulder active range of motion
Shoulder external rotation and internal rotation range of motion in shoulder flexion 90 degrees in supine. An inclinometer will used for the test. The test will perform 3 times. Data will report as mean values for each trial. (unit of measure: degree, °)
Shoulder passive range of motion
Shoulder external rotation and internal rotation range of motion in shoulder flexion 90 degrees in supine. An inclinometer will used for the test. The test will perform 3 times. Data will report as mean values for each trial. (unit of measure: degree, °)
Degree of shoulder and scapular kinematics during arm elevation
The kinematics is assessed using an electromagnetic motion tracking system (VIPERTM, Polhemus, USA) to collect the glenohumeral elevation, horizontal abduction/adduction, internal/external rotation, scapulothoracic retraction/protraction, upward/downward rotation, anterior/posterior tilt during arm elevation. During the test, participants performed 5 arm elevations, with 60 seconds of rest between each trial. Data will report as mean values for each trial. (unit of measure: degree, °)
Amplitude of the activation of glenohumeral and periscapular muscles during arm elevation
The muscle activation amplitude of the upper trapezius, lower trapezius, serratus anterior, latissimus dorsi, pectoralis major, biceps brachii, and triceps brachii would be recorded during arm elevation. During the test, participants performed 5 arm elevations, with 60 seconds of rest between each trial. The data will be reported as mean values for each trial. (unit of measure: percentage, %)
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