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Sportverletz Sportschaden 1993 Sep;7(3):136-142

Compression neuropathy of the suprascapular nerve in high performance volleyball players.

Eggert S, Holzgraefe M

Ev. Waldkrankenhaus Spandau, Berlin.

Individual observations during the course of the medical care of the German men's national volleyball team in international tournaments gave cause to investigate more thoroughly the increasing occurrence of an atrophy of the infraspinatus m. in volleyball players at international level. An examination of three men's national teams specially slanted to throw light on this problem revealed that 28% (10 out of 36 players) had an atrophy of the infraspinatus m. On the basis of these findings, a prospective study was carried out, with the object of clarifying to what extent a developing or manifest compression neuropathy of the suprascapularis n. was present in a defined population of high-level volleyball players (1st National League, men). 32 players were examined as to the extent to which a functional impairment of the suprascapularis n. occurred in the pursuit of the competitive sport of volleyball. The study revealed a functional impairment of the suprascapular n. in 45% of the both clinically and neurophys iologically examined sportsmen. It follows in consequence that a control examination is advisable in the case of a latent disorder, so as to detect any continuation or possible deterioration. In the event of a developing or manifest atrophy of the infraspinatus m. the operative relief of the suprascapular n. in the region of the scapular incisure may be considered in addition to conservative therapy.


Schweiz Z Sportmed 1991 Sep;39(3):113-118

Paralysis of the suprascapular nerve and tennis. Apropos of 3 groups of professional players.

[Article in French]

Daubinet G, Rodineau J

Hopitaux de Paris.

A recent surge of interest for tennis has given rise to an increased incidence of injuries to the N. suprascapularis. The early symptoms of this pathology are often missed, leading subsequently to a chronic condition, including an irreversible trauma to the nerve. Nevertheless, through the study of three groups of professional tournament players, we were able to show that the neurological injury is reversible if the diagnosis is established early on and if the hurting movement is avoided until full recovery. A backhand stroke done with both arms seems to have a protective effect against this pathology.


Can J Neurol Sci 1995 Nov;22(4):301-304

Isolated suprascapular nerve palsy: a review of nine cases.

Berry H, Kong K, Hudson AR, Moulton RJ

Division of Neurology, St. Michael's Hospital, Toronto, Ontario, Canada.

BACKGROUND: In nine patients, suprascapular nerve palsy followed serious accidents associated with fractures of the cervical vertebrae, clavicle or scapula and after weight lifting, wrestling and a fall on the elbow or shoulder. METHOD: All patients were examined as to muscle wasting, weakness and shoulder fixation. EMG examination was done in all cases and six patients underwent surgical exploration. RESULTS: The palsy was incomplete on clinical and EMG examination in all patients. On exploration, scarring, entrapment, tethering or kinking at the suprascapular notch was four and two had post-traumatic neuromas. CONCLUSIONS: In contrast to published studies, none of our patients presented with shoulder pain, a spontaneous onset nor with involvement limited to the infraspinatus muscle. The differential diagnosis should include C5 root lesion, brachial plexus neuritis, frozen shoulder and tear of the rotator cuff.


Br J Sports Med 1994 Sep;28(3):177-179

Prevalence of latent and manifest suprascapular neuropathy in high-performance volleyball players.

Holzgraefe M, Kukowski B, Eggert S

Department of Neurology, University Hospital, Gottingen, Germany.

The aim of the present study was to evaluate the prevalence of latent and manifest suprascapular neuropathy in high-level male volleyball players. Thirty subjects were examined clinically and electrophysiologically. Suprascapular neuropathy, most probably at the level of the suprascapular notch, was demonstrated in 12 subjects, being latent in eight. Taking into account our clinical findings in a further 36 international-level players, a remarkably high overall prevalence of suprascapular nerve lesion of 33% (22 of 66 subjects) was found. All cases involved the side of the body with the player's smashing arm. These findings suggest that careful monitoring of suprascapular nerve function may be useful in high-performance volleyball players, as early diagnosis is essential to prevent more severe damage.


Acta Neurol Scand 1993 Mar;87(3):248-250

Suprascapular neuropathy restricted to the infraspinatus muscle in volleyball players.

Montagna P, Colonna S

Institute of Clinical Neurology, University of Bologna, Italy.

Six volleyball players developed weakness and atrophy of the infraspinatus muscle on the dominant side. Electromyography (EMG) disclosed denervation and motor unit loss restricted to the infraspinatus muscle, the supraspinatus and other shoulder muscles remaining normal. Infraspinatus neuropathy may occur as a professional hazard in volleyball players. A lesion of the suprascapular nerve at the spinoglenoid notch is implied.


J Neurosurg 1991 Jun;74(6):893-896

Suprascapular nerve entrapment. A series of 27 cases.

Callahan JD, Scully TB, Shapiro SA, Worth RM

Department of Surgery, Indiana University Medical Center, Indianapolis.

Suprascapular nerve entrapment is an acquired neuropathy secondary to compression of the nerve in the bony suprascapular notch. A series of 27 cases, the largest reported to date, is presented and examined as to the best and most appropriate method of diagnosis and treatment. The entity is described in detail as to its origin, anatomy, and pathophysiology.


Br J Sports Med 2000 Jun;34(3):174-80

Suprascapular neuropathy in volleyball players.

Witvrouw E, Cools A, Lysens R, Cambier D, Vanderstraeten G, Victor J, Sneyers C, Walravens M.

BACKGROUND: Suprascapular nerve entrapment with isolated paralysis of the infraspinatus muscle is uncommon. However, this pathology has been reported in volleyball players. Despite a lack of scientific evidence, excessive strain on the nerve is often cited as a possible cause of this syndrome. Previous research has shown a close association between shoulder range of motion and strain on the suprascapular nerve. No clinical studies have so far been designed to examine the association between excessive shoulder mobility and the presence of this pathology. AIM: To study the possible association between the range of motion of the shoulder joint and the presence of suprascapular neuropathy by clinically examining the Belgian male volleyball team with respect to several parameters. METHODS: An electromyographic investigation, a clinical shoulder examination, shoulder range of motion measurements, and an isokinetic concentric peak torque shoulder internal/external rotation strength test were performed in 16 professional players. RESULTS: The electrodiagnostic study showed a severe suprascapular neuropathy in four players which affected only the infraspinatus muscle. In each of these four players, suprascapular nerve entrapment was present on the dominant side. Except for the hypotrophy of the infraspinatus muscle, no significant differences between the affected and non-affected players were observed on clinical examination. Significant differences between the affected and non-affected players were found for range of motion measurements of external rotation, horizontal flexion and forward flexion, and for flexion of the shoulder girdle (protraction); all were found to be higher in the affected players than the non-affected players. CONCLUSIONS: This study suggests an association between increased range of motion of the shoulder joint and the presence of isolated paralysis of the infraspinatus muscle in volleyball players. However, the small number of patients in this study prevents definite conclusions from being drawn.

Am J Sports Med 1990 May;18(3):225-228

Suprascapular nerve injuries with isolated paralysis of the infraspinatus.

Black KP, Lombardo JA

Medical College of Wisconsin, Department of Orthopaedic Surgery, Milwaukee 53226.

Nerve lesions are frequently overlooked in the differential diagnosis of shoulder pain, and there have been few reports in the literature of injuries of the supracapsular nerve that involve only the infraspinatus. We report four cases of suprascapular nerve injuries which involve solely the infraspinatus in which each patient presented with shoulder pain and weakness. The diagnosis can be suspected by careful history and physical examination, but must be confirmed by the appropriate electrical studies. Our patients required 6 months to 1 year to regain full function, and isokinetic testing revealed near normal return of strength. Further diagnostic work-up and surgery may be necessary for those cases which fail to demonstrate satisfactory improvement in the expected time period.

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