Shoulder Strength and Physical Activity Predictors of Shoulder Pain in People With Paraplegia From Spinal Injury

Shoulder joint pain is a common secondary complaint for individuals after spinal cord injury (SCI). To determine predictors of shoulder joint pain in persons with paraplegia. 223 participants enrolled. 39.8% developed shoulder pain over the 3-year follow-up period. Demographic variables and higher activity levels were not related to shoulder pain onset. Baseline maximal isometric torque (normalized by body weight) in all shoulder muscle groups was 10 to 15% lower in those who developed shoulder pain compared to those who remained pain-free. Lower shoulder adduction torque was a significant predictor of shoulder pain development (Log-Likelihood test = 11.38, p < 0.001), but the model explained only 7.5% of shoulder pain onset and consequently is of limited clinical utility.

Those who developed shoulder pain had reduced muscle strength, particularly in the shoulder adductors, and lower levels of physical activity prior to the onset of shoulder pain. Neither factor was a strong predictor of the development of shoulder pain.