Decrease Shoulder Pain

With Wheelchair Tennis?

January 9, 2020

Manual wheelchair users rely heavily on upper extremities for mobility purposes. Not only for propulsion of their wheelchair, but also for transfers in and out of the wheelchair for everyday mobility needs. The increased demand on shoulder joints can eventually lead to shoulder and upper extremity pain as well as dysfunction.


According to reports, up to 78 percent of individuals with spinal cord injury who use a manual wheelchair will have shoulder pathology. There is a good amount of published literature that has identified specific factors that influence increased shoulder dysfunction. Muscle imbalances, posture, and repetitive use in dysfunctional shoulder movement patterns all contribute to increased shoulder pathology.


In recent years, there has been a rise in popularity for disabled sports. ADVERTISEMENT Wheelchair users increasing their frequency in sport participation will impact the musculoskeletal load upon their shoulders. Research shows that the prevalence of shoulder pain and dysfunction is high in both athletic and non-athletic wheelchair users. Knowing that shoulder pain is likely to occur with manual wheelchair users poses some questions:


How much load should a wheelchair user place on his or her shoulders in order to protect functional mobility? Are there differences in incidence of shoulder pain with an active wheelchair user versus a sedentary wheelchair user? If an active individual is using his or her shoulders more to participate in a sport activity, should more stress on the body result in more injury?


A research article by Heather Fullerton in the Journal of Medicine and Science in Sports and Exercise looked to answer some of these questions. In one study, questionnaires were sent to 257 wheelchair users to look into the prevalence of shoulder pain.


They compared wheelchair users who participated in sport versus sedentary wheelchair users. Researchers asked questions such as what sports do they participate in, how many hours of training, how many years in a wheelchair, level of spinal cord injury, etc.


A few interesting findings came out of the study. First, in the non-athletic population, 66 percent of participants reported shoulder pain compared to only 39 percent of the athletic population. This suggests that more active wheelchair users have less risk of shoulder pain compared to non-active wheelchair users. Additionally, 26 percent of the study participants indicated they played wheelchair tennis.


A second conclusion is that individuals who participate in wheelchair sports enjoy more years free of shoulder pain compared to the non-active wheelchair user. In the study, data showed the active wheelchair users had an average of 12 years without shoulder pain after becoming a manual wheelchair user. The non-athlete wheelchair user only was without shoulder pain for an average of 8 years.


It is commonly thought that shoulder injuries are due to overuse. If this were the case, the active wheelchair users would have more use due to their involvement in sport. However, the study showed that more active individuals had less pain and more years of having a pain free shoulder after a spinal cord injury.


This suggests that a sporting activity, such as wheelchair tennis, has a protective effect on one’s shoulder. The study, however, does not explain the cause of this and further research is needed to look more closely into these areas.


The answer to the initial question posed in this blog is yes, wheelchair tennis can decrease risk for shoulder pain. The goal is to stay active, and make tennis a part of your fitness and overall wellness plan. Suggested next steps include: find your local wheelchair tennis group, grab your rackets, get to the courts, and have fun.


Matt McCoy, PT, is a physical therapist with Baylor Scott and White Institute for Rehabilitation in Dallas, Teaxas, as well as the chair of the USTA Texas Sports Science Committee and a USTA National Wheelchair Committee member.



HEATHER D. FULLERTON; JEFFREY J. BORCKARDT; and ALAN P. ALFAN; Shoulder Pain: A Comparison of Wheelchair Athletes and Nonathletic Wheelchair Users, MEDICINE & SCIENCE IN SPORTS & EXERCISE, 2003.

Omar W. Heyward, Riemer J. K. Vegter*, Sonja de Groot, Lucas H. V. van der Woude, Shoulder complaints in wheelchair athletes: A systematic review:


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