Comparison of rotator cuff muscle thickness and acromiohumeral distance in overhead adolescent athletes with and without rounded shoulders

J Ultrasound. 2025 Dec 5. doi: 10.1007/s40477-025-01102-y. Online ahead of print.

Abstract

Purpose: Shoulder injuries, particularly in athletes engaged in overhead sports, are common and debilitating, often resulting from overuse and improper posture. Rounded shoulder deformity is a postural abnormality linked to shoulder dysfunction and rotator cuff imbalances. Therefore, the current study compares rotator cuff muscle thickness and acromiohumeral distance (AHD) in overhead athletes with and without rounded shoulders.

Methods: In this cross-sectional research, 32 overhead athletes were divided into groups with and without rounded shoulders. The measurements were taken via ultrasound (Versana Premier, GE Healthcare, South Korea) to assess muscle thickness and acromiohumeral distance. The Image J software measured the rounded shoulder angle using the photogrammetric method. For data analysis, an independent T-test was used at the significant level of 95% (α < 0.05).

Results: There were no significant differences in supraspinatus (P < 0.250), infraspinatus (P < 0.449), teres minor (P < 0.353), and subscapularis (P < 0.823) thicknesses. Also, there was no significant difference in acromiohumeral distance (P < 0.139) among overhead adolescent athletes with and without rounded shoulders.

Conclusion: There is no significant difference between the two groups in the thickness of the shoulder muscles and the acromiohumeral distance. Further research should be conducted on the possible effect of age, sports history, and duration of rounded shoulder on the results. However, it should be kept in mind that the assessment of muscle thickness may not be a suitable indicator for evaluating the muscular performance of athletes during sports.

Keywords: Acromiohumeral distance; Athletes; Posture; Rounded shoulders; Ultrasonography.