Shoulder pain in wheelchair rugby athletes: Athlete characteristics, training behaviors, and rehabilitation implications

Shoulder pain is a common concern among wheelchair users and may be influenced by adaptive sports. Although participation in adaptive sports is increasing, limited research has examined shoulder pain in this population. This cross-sectional survey investigated the prevalence and severity of shoulder pain and explored associations with demographic factors, activity patterns, and management strategies among 61 wheelchair rugby athletes in the United States. The Wheelchair User’s Shoulder Pain Index (WUSPI) measured pain, with an average score of 56.08 (performance-corrected score (PC-WUSPI) = 58.13), reflecting high levels of shoulder pain. Significant negative correlations (ps < 0.001) were found between PC-WUSPI scores and years of wheelchair use (r = -0.48), adaptive sports participation (r = -0.47), warm-up frequency (r = -0.53), and shoulder strength training (r = -0.34). A positive correlation was observed with power wheelchair use (r = 0.51, p < 0.001). Most participants managed shoulder pain with medication (67.2%) or exercise (57.4%), with medication rated as more effective. The most common medical services utilized for pain management were physical therapy (54.1%), occupational therapy (44.3%), and primary care physicians (41%). Findings highlight the need for targeted prevention and rehabilitation strategies to address shoulder pain in wheelchair rugby athletes, emphasizing proactive conditioning and multidisciplinary approaches.