Asymptomatic Elite Adolescent Tennis Players' Signs of Tendinosis in Their Dominant Shoulder Compared With Their Nondominant Shoulder

J Athl Train. 2015 Dec;50(12):1299-305. doi: 10.4085/1062-6050-51.1.07. Epub 2015 Dec 10.


Context: Tennis is an asymmetric overhead sport with specific muscle-activation patterns, especially eccentrically in the rotator cuff. Magnetic resonance imaging (MRI) findings in asymptomatic adolescent elite tennis players have not previously been reported.

Objective: The first aim of the study was to describe MRI findings regarding adaptations or abnormalities, as well as muscle cross-sectional area (CSA), of the rotator cuff. The second aim of the study was to investigate the rotator cuff based on the interpretation of the MRI scans as normal versus abnormal, with the subdivision based on the grade of tendinosis, and its association with eccentric rotator cuff strength in the dominant arm (DA) of the asymptomatic elite adolescent tennis player.

Setting: Testing environment at the radiology department of Medicinsk Röntgen AB.

Patients or other participants: Thirty-five asymptomatic elite tennis players (age = 17.4 ± 2.7 years) were selected based on ranking and exposure time.

Intervention(s): We assessed MRI scans and measured the CSA of the rotator cuff muscle. The non-DA (NDA) was used as a control. In addition, eccentric testing of the external rotators of the DA was performed with a handheld dynamometer.

Results: The DA and NDA displayed different frequencies of infraspinatus tendinosis (grade 1 changes) (P < .05). Rotator cuff measurements revealed larger infraspinatus and teres minor CSA (P < .05) in the DA than in the NDA. Mean eccentric external-rotation strength in the DA stratified by normal tendon and tendinosis was not different between groups (P = .723).

Conclusions: Asymptomatic adolescent elite tennis players demonstrated infraspinatus tendinosis more frequently in the DA than in the NDA. Clinicians must recognize these tendon changes in order to modify conditioning and performance programs appropriately.

Keywords: adolescents; magnetic resonance imaging; overhead athletes; tennis.

MeSH terms

  • Adolescent
  • Asymptomatic Diseases
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Physical Examination
  • Rotation
  • Rotator Cuff / anatomy & histology
  • Rotator Cuff / pathology
  • Rotator Cuff / physiopathology
  • Rotator Cuff Injuries*
  • Shoulder Injuries*
  • Shoulder Joint / anatomy & histology
  • Shoulder Joint / pathology
  • Shoulder Joint / physiopathology
  • Tendinopathy / diagnosis*
  • Tennis / injuries*
  • Tennis / physiology
  • Young Adult