Strength reduction in unilateral shoulder pain: Is the healthy side really healthy in rotator cuff disease?

Objective The primary aim was to ascertain whether unilateral shoulder pain is implicated in strength reduction both on the ipsilateral and contralateral side. Secondarily, we aimed to determine whether strength was affected by sonographic tendon abnormalities. Design A total of 122 subjects were evaluated. Sixty-six female subjects with unilateral shoulder pain in the dominant arm were recruited. Abduction strength was measured in both the dominant and nondominant arm. High-resolution ultrasonography was also conducted on both shoulders. A match-paired control group (n = 66) composed of healthy volunteers underwent the same strength and sonography tests. Subjects with any radiographic anomaly were excluded from the control group. A mixed analysis of variance was performed to test the effect of unilateral shoulder pain on abduction strength. The effect of tendinopathy on shoulder strength was investigated using a mixed 2 x 2 analysis of variance. Results Analysis of variance showed that patients with dominant shoulder pain had lower shoulder strength (11.65 4.05 kg) when compared with controls (14.37 +/- 4.00 kg; F = 10.454, P = 0.002). No statistically significant effects were found when comparing subjects with and without tendinopathy among the study group. Conclusions In patients with unilateral shoulder pain, abduction strength was found to be lower both on the ipsilateral and contralateral side. The presence of tendinopathy did not affect the reduction in strength. Future research is needed to substantiate these findings.