A case report of shoulder fatigue imbalance in wheelchair rugby: implications to pain and injury

Spinal Cord Series and Cases, 2016 · DOI: 10.1038/scsandc.2016.2 · Published: July 7, 2016

Simple Explanation

This study examined muscle fatigue in a wheelchair rugby player to understand its impact on shoulder pain and injury. Unlike continuous wheelchair pushing, acute muscle imbalances between agonists and antagonists (that is, push and recovery muscles) were not demonstrated. Wheelchair sports such as rugby may reduce risk of shoulder pain and overuse injury due to intermittent activity rather than continuous pushing.

Study Duration

2 days

Participants

One 39-year-old male with a C6 complete spinal cord injury

Evidence Level

Level 4: Case-control study

Key Findings

1
Agonist–antagonist balance was observed rather than imbalance during wheelchair rugby training sessions.
2
The study found a symbiotic relationship between agonist and antagonist muscles, where they compensated for each other's fatigue to maintain joint stability.
3
Intermittent wheelchair sport activity (rugby in this case) may reduce the risk of acute muscle imbalances, potentially decreasing shoulder pain and injury.

Research Summary

The purpose of this study was to document agonist–antagonist imbalance between push-phase and recovery-phase muscles during actual wheelchair sport activity. Our ﬁndings indicate that fatigue is present in wheelchair pushing agonists (that is, AD and PM) and antagonists (that is, PD) across and within wheelchair rugby training. Fortunately, the typical push-recovery muscle imbalance seen during continuous pushing was not present in the intermittent rugby activity.

Practical Implications

Therapeutic Exercise

Wheelchair rugby can be used as an alternative to traditional rehabilitation exercise.

Injury Prevention

Intermittent sports activity may reduce the risk of shoulder pain and overuse injuries.

Gameplay Strategy

Coaches and athletes can focus on gameplay strategies that leverage the agonist–antagonist balance to optimize performance and minimize fatigue.

Study Limitations

1
The current case participant demonstrated less fatigue than a teammate with triceps function (data not published).
2
Also, we did not report data of other push-phase agonists (for example, biceps brachii) or antagonists.
3
Data were not reported for rest times but future research should examine continuous, uninterrupted training activity.

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