| Kuppens et al.3131 Kuppens K, Feijen S, Roussel N, Nijs J, Cras P, van Wilgen P, Struyf F. Training volume is associated with pain sensitivity, but not with endogenous pain modulation, in competitive swimmers. Phys Ter Sport. 2019;37:150-6.
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To evaluate the relationship between pain threshold and training volume in competitive swimmers, using static (pressure pain threshold - PPT) and dynamic (conditioned pain modulation) measurement tools. |
Digital Algometer (Wagner Instruments, Greenwich, CT, USA). PPT measurement sites:
upper trapezius, dorsal side of the middle phalanx of the third finger, proximal third of the calf muscle.
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Average swimming training: 11.6 h/week. PPT associated with conditioned pain modulation: external painful stimulus applied to the upper portion of the non-dominant upper limb during PPT reassessment was superior to isolated PPT measurement;
Swimmers exposed to a higher volume of training showed higher PPT, indicating less sensitization to pain in these athletes;
Swimmers with lower training volume obtained lower PPT;
There was no correlation between training volume and conditioned pain modulation as a measure of endogenous pain modulation capacity.
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Pain perception may be influenced by the volume of swim training;
Swimmers who had a greater number of hours of training obtained higher PPT in various parts of the body, indicating less sensitization to pain and possible training-induced hypoalgesia;
No associations were found between training load and measures of endogenous pain inhibition.
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| Hidalgo-Lozano et al. 3333 Ortega-Santiago R, González-Aguado ÁJ, Fernández-de-Las-Peñas C, Cleland JA, de-la-Llave-Rincón AI, Kobylarz MD, Plaza-Manzano G. Pressure pain hypersensitivity and referred pain from muscle trigger points in elite male wheelchair basketball players. Braz J Phys Ter. 2020;24(4):333-41.
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To evaluate and compare PPT, presence of active and latent trigger points in elite swimmers with and without shoulder pain and in healthy elite athletes. |
Mechanical pressure algometer (Pain Diagnosis and Treatment Inc., Great Neck, NY, USA).
PPT measurement sites:
Elevator of the scapula
Sternocleidomastoid
Upper trapezius
Scalene
Infra-spinal
Subscapular
Tibialis anterior
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Swimmers in pain:
65% had pain during training;
PPT lower than the control group;
Fewer active trigger points.
Swimmers without pain:
Lower PPT than the control group in the upper trapezius, subscapular, and anterior tibial muscles;
Higher number of latent trigger points.
No significant difference in PPT and trigger points between the groups with and without pain;
Higher number of trigger points in the groups with and without pain than in the control group (healthy athletes from other sports).
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Elite swimmers with and without shoulder pain showed lower PPT values compared to the group of healthy athletes;
Low PPT values were also found in the tibialis anterior in swimmers with and without shoulder pain, suggesting the presence of CS in these athletes;
Elite swimmers with and without pain showed peripheral and central sensitization;
Findings of active trigger points in the shoulder/neck directly contributed to pain complaint in elite swimmers;
Similar PPT were found between the two groups of swimmers, suggesting that elite swimmers may be predisposed to develop a degree of mechanical sensitization related to the specific physical demands of swimming.
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| Habechian et al.3232 Hidalgo-Lozano A, Fernández-de-las-Peñas C, Calderón-Soto C, Domingo-Camara A, Madeleine P, Arroyo-Morales M. Elite swimmers with and without unilateral shoulder pain: Mechanical hyperalgesia and active/latent muscle trigger points in neck-shoulder muscles. Scand J Med Sci Sport. 2011;23(1):66-73.
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To compare scapular kinematics, scapulo-thoracic muscle activation, and PPT at the shoulder in young non-sport players, amateur swimmers, and competitive swimmers. |
Digital Algometer (model OE-220; ITO Physiotherapy & Rehabilitation, Saitama, Japan).
PPT measurement sites:
• Superior trapezius
• Infra-spinal
• Supraespinal
• Middle deltoid
• Tibialis anterior
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Competitive swimmers presented:
Greater internal rotation of the scapula - at 90° and 120° of shoulder elevation - and anterior tilt of the scapula - at 90° of shoulder elevation - compared to non-athletes;
Greater activation of the serratus anterior between 60° and 120° of shoulder elevation compared to amateur swimmers, and from 90° to 120° compared to non-competitive individuals;
Greater anterior scapular tilt of amateur swimmers between 90° and 120° of shoulder elevation compared to non-swimmers;
No difference in upper and lower trapezius muscle activation between groups;
No difference in PPT between groups in all muscles evaluated;
There was no correlation between scapular kinematics and PPT.
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Young competitive swimmers showed changes in scapular kinematics and scapulothoracic muscle activation during shoulder elevation that may be related to the sport practice;
Mechanical pain sensitivity (PPT) was not altered in the evaluated young swimmers.
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| Ortega-Santiago et al. 3434 Kafkas AS, Kafkas ME, Durmus B, Açak M. Effects of a tennis tournament on players’ hand grip strength, pressure pain threshold and visual analogue scale. Med Dello Sport. 2014;67:569-79.
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To investigate the presence of PPT and trigger points in the shoulder/neck muscles in elite male wheelchair basketball athletes. |
Mechanical pressure algometer.
Measurement sites of the PPT:
Between the zygapophyseal joint between C5 and C6 Deltoid
Second metacarpal
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Wheelchair Basketball Group with shoulder pain:
Mean duration of shoulder pain of two years;
Lower bilateral PPT at the shoulder, at the zygapophyseal joint between C5 and C6 and at the second metacarpal compared to the other groups;
Higher number of active trigger points compared to the other groups.
Wheelchair Basketball Group without shoulder pain:
Difference in the number of trigger points in the upper trapezius compared to the group with pain, showing higher number of latent trigger points in this muscle.
All groups present a similar number of latent trigger points.
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Hypersensitivity and a significant number of active trigger points in elite wheelchair basketball athletes with shoulder pain compared to asymptomatic players of the same sport and traditional basketball;
No differences were found between wheelchair basketball athletes without shoulder pain and traditional basketball athletes.
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| Kafkaset et al.3535 Jones MD, Nuzzo JL, Taylor JL, Barry BK. Aerobic exercise reduces pressure more than heat pain sensitivity in healthy adults. Pain Med. 2019;20(8):1534-46.
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To evaluate changes in palm grip strength and PPT during amateur tennis competition. |
Digital algometer (Chatillon DFE-100, Digital Force Gauge/AMETEK).
Sites for measuring the PPT:
Lateral epicondyle
Trapezius
Deltoid
Supraespinal
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Both groups with ↓PPT in the lateral epicondyle, trapezius and deltoid after each day of competition compared to the first day.
Female tennis players:
Lower PPT in the supraspinatus after the third day of competition;
Lower palm grip strength after second, third and fourth day of competition;
Increased pain intensity measured using the Visual Analog Scale for pain after second, third and fourth days of competition.
Male tennis players presented:
Lower PPT in the supraspinatus after the fourth day of competition;
Lower palm grip strength after third and fourth day of competition;
Increased pain intensity after the third and fourth day of competition.
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PPT and grip strength values decreased, while pain intensity increased over the competition days;
This tournament sport has a heavy overload schedule that may affect PPT in the upper limbs;
It is assumed that consecutive days of competition may contribute substantially to overload injuries in tennis players.
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