J Korean Orthop Assoc.  2022 Jun;57(3):213-222. 10.4055/jkoa.2022.57.3.213.

Characteristics of Gradual-Onset Shoulder Pain Due to Non-Contact Mechanism in Recreational-Level Beginning Surfers in Korea: Preliminary Study Based on the Ultrasound Findings Performed at Single Institutes

• Kim SK
• Park TJ
• Shon MS

• KMID: 2530667
• DOI: http://doi.org/10.4055/jkoa.2022.57.3.213

Abstract

Purpose
This study examined the characteristics based on the ultrasound findings of non-contact, gradual-onset shoulder pain in recreational-level surf beginners with a surf experience of one year or less and the treatment outcomes.
Materials and Methods
From January 2019 to May 2020, 34 patients with gradual-onset shoulder pain from recreational-level surfing activity who visited outpatient clinics were analyzed retrospectively with prospective data collection. All patients had a surf experience of one year or less as surf club members. The demographic data, including the surf-specific data and physical test, were reviewed. Simple radiographs and ultrasound of both shoulders were performed for an initial evaluation in all patients. If needed, magnetic resonance images were taken for an additional evaluation. Conservative treatments, including medication or injection, combined with trunk extension, periscapular, and core muscle training were performed in all cases. The clinical outcomes were evaluated using the visual analog scale for pain (PVAS), the Simple Shoulder Test (SST) score at the initial and final follow-up, and the patient’s level of satisfaction with treatment.
Results
Thirty-two patients (94.1%) showed minor symptoms. The clinical findings were predominantly divided into periscapular or pectoralis muscle strain (14.7%), proximal biceps tendinopathy (38.2%), subacromial impingement (44.1%), and shoulder instability (2.9%). The common findings in ultrasound were effusion around the biceps tendon, cuff tendinosis, and subacromial bursitis. The mean PVAS and SST score improved significantly at the last follow-up (p<0.001, p<0.001). The patient’s satisfaction with treatment ranged from ‘satisfied’ to ‘very satisfied’ in 31, ‘so so’ in two, and ‘dissatisfied’ in one patient.
Conclusion
This study showed that the common pathologic conditions of shoulder pain in recreational-level beginners with a surf experience of one year or less are tendinopathy around the long head of the biceps tendon and rotator cuff. Ultrasound was helpful in rapidly diagnosing and determining the treatment plans during the primary diagnostic approach at the outpatient visit. Most cases were associated with minor symptoms that did not interfere with work or surfing and showed relatively satisfactory results for conservative treatments combined with functional muscle training.

Keyword

surfing; shoulder; tendinopathy; diagnostic imaging; ultrasound