It has been well established in previous editions of MD Health’s article and comment series that the presence of structural changes or structural pathology doesn’t always necessarily correlate with pain or symptoms.

Yet another study recently published has questioned the relevancy of MRI/imaging findings, and explored their correlation to pain, this time in elite volleyball athletes.

The study by Lee (2019) looked at 26 elite male and female volleyball athletes who underwent shoulder MRI’s on their dominant arms. All these athletes had no symptoms reported, and no apparent injuries present on a physical examination.

Of the 26 athletes studied, 23 had some sort of pathological finding on their MRI results, despite having no symptoms present. These injuries including rotator cuff tendinopathies, rotator cuff tears and labral tears.

This study proved that despite pathology being presence on imaging, a lot of the time there is no symptoms preventing function or participation in sporting activities.

Again, this is highly relevant to the wider population, as scans do not illustrate the entire picture when it comes to treating pain. Every medical/rehab professional should strive to treat the person, not the pathology. A full subjective and medical history, PLUS a full physical examination by a qualified physiotherapist, exercise physiologist or sports medicine doctor; not just medical imaging, is paramount to get the best, most sustainable results for each individual.


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Shoulder MRI in asymptomatic elite volleyball athletes shows extensive pathology

 Elite overhead athletes, such as volleyball players, are predisposed to shoulder injuries due to repetitive overhead movement and overloading of the shoulder joint and surrounding muscles and ligaments. Returning to play at an elite level following shoulder surgery is often not possible. We hypothesised that MRI of elite volleyball players’ dominant shoulders would demonstrate extensive asymptomatic shoulder pathology that does not prevent the athlete from competing. 

Author: Will Ryan

Will grew up in Wagga Wagga, NSW, before moving to Albury to study physiotherapy at Charles Sturt University. He has previously worked as a gym attendant and Pool Lifeguard at the Kapooka Army Base near Wagga, and has also had experience in sports training with Jindera and Mangoplah Football Clubs. He is a die-hard Collingwood supporter, currently plays mixed netball and goes waterskiing in the summer. Will has a special interest in the progression from rehabilitating injuries to returning to full function and injury prevention, utilising Strength and Conditioning principles into his programming. Will has completed several courses around this area, including strength and conditioning, spinal and sports physiotherapy courses. He is currently studying a Graduate Certificate in Musculoskeletal Physiotherapy at La Trobe University.

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