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Increased shoulder pain across an exercise session and subsequent shoulder exercise: a prospective cohort study
Jeanette Trøstrup1,2, Susanne Wulff Svendsen3, Annett Dalbøge4,5
1Elective Surgery Centre, Silkeborg Regional Hospital, 8600, Silkeborg, Denmark. jeatro@rm.dk.
BMC Musculoskeletal Disorders
|July 29, 2022
Summary
Increased shoulder pain during exercise did not reduce subsequent exercise dose for employees with shoulder complaints. Fear-avoidance beliefs did not influence this relationship, suggesting pain is not a barrier to rehabilitation progression.
Area of Science:
- Musculoskeletal Rehabilitation
- Occupational Health
- Pain Management
Background:
- Shoulder complaints are prevalent, with exercise therapy as the primary treatment.
- The impact of exercise-induced shoulder pain on subsequent exercise dosage, especially in individuals with high fear-avoidance beliefs, is not well understood.
- Understanding this relationship is crucial for optimizing shoulder rehabilitation strategies.
Purpose of the Study:
- To investigate if increased shoulder pain during an exercise session affects the subsequent exercise dose.
- To determine if high fear-avoidance beliefs exacerbate the association between increased pain and reduced exercise dose.
Main Methods:
- A prospective cohort study utilized data from a randomized controlled trial (ClinicalTrials.gov ID: NCT03159910).
- Participants included 79 employees with shoulder complaints and high occupational shoulder exposures.
- A 2-3 month home-based or partly supervised exercise program was implemented. Linear mixed models analyzed associations between pain changes and exercise dose (repetitions, progression, resistance, time between sessions).
Main Results:
- A 1-cm increase in shoulder pain during exercise was not significantly associated with changes in the number of repetitions, progression level, or resistance level.
- The time until the next exercise session also showed no significant association with increased pain during the previous session.
- No significant interactions were found between increased pain and fear-avoidance beliefs regarding exercise dose.
Conclusions:
- Increased shoulder pain during exercise sessions does not appear to be a barrier to subsequent exercise dose in employees with shoulder complaints.
- Fear-avoidance beliefs did not modify the relationship between exercise-induced pain and exercise dose.
- These findings suggest that current exercise regimens can be continued even with moderate pain increases during exercise for this population.
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