Int J Sports Med 2014; 35(03): 232-237
DOI: 10.1055/s-0033-1345179
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

Psychological Influences Predict Recovery Following Exercise Induced Shoulder Pain

J. Parr
1   Comprehensive Center for Pain Research, University of Florida, Gainesville, United States
,
P. Borsa
2   Applied Physiology & Kinesiology, University of Florida, Gainesville, United States
,
R. Fillingim
3   Community Dentistry and Behavioral Science, University of Florida, ­Gainesville, United States
,
K. Kaiser
4   Kinesiology, University of Calgary, Calgary, Canada
,
M. D. Tillman
5   Kinesiology and Health Promotion, Troy University, Troy, AL United States
,
T. M. Manini
6   Aging and Geriatric Research, University of Florida, Florida, United States
,
C. Gregory
7   Health Sciences and Research, Medical University of South Carolina, ­Charleston, United States
,
S. George
8   Physical Therapy, University of Florida, Gainesville, United States
› Author Affiliations
Further Information

Publication History



accepted after revision 15 April 2013

Publication Date:
10 September 2013 (online)

Abstract

Predicting recovery following muscle injury can be difficult because it involves consideration of multiple factors. Our objective was to determine if psychological factors, sex, and peak pain and disability ratings could be predictive of delayed recovery following induced muscle injury. Healthy untrained volunteers (n=126; M:F 51:75) underwent a concentric/eccentric isokinetic exercise protocol on their dominant shoulder to induce fatigue, with individuals who reported pain (>0/10) at 96 h being classified as “not recovered”. Individuals experiencing pain at 48 h were more likely not to be recovered (O.R.=1.62, p<0.001). Additionally, individuals with higher scores in pain catastrophizing at 48 h were more likely to experience pain at 96 h (O.R.=1.06, p<0.001). Pain duration (in days) was associated with pain scores at 48 h (β=0.385, p<0.001) and baseline anxiety (β=0.220, p=0.007). Fear of movement/re-injury at 96 h was found to be associated with pain catastrophizing at 48 h (β=0.537, p<0.001) and baseline levels of fear of pain (β=0.217, p=0.004). This study provides preliminary evidence that higher pain levels and pain catastrophizing following acute muscle injury are associated with poor recovery, higher fear of movement/re-injury and longer pain duration.

 
  • References

  • 1 Beaton DE, Wright JG, Katz JN. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am 2005; 87: 1038-1046
  • 2 Borsa PA, Sauers EL. The importance of gender on myokinetic deficits before and after microinjury. Med Sci Sports Exerc 2000; 32: 891-896
  • 3 Byerly PN, Worrell T, Gahimer J, Domholdt E. Rehabilitation compliance in an athletic training environment. J Athl Train 1994; 29: 352-355
  • 4 Carpenter JE, Blasier RB, Pellizzon GG. The effects of muscle fatigue on shoulder joint position sense. Am J Sports Med 1998; 26: 262-265
  • 5 Chmielewski TL, Jones D, Day T, Tillman SM, Lentz TA, George SZ. The association of pain and fear of movement/reinjury with function during anterior cruciate ligament reconstruction rehabilitation. J Orthop Sports Phys Ther 2008; 38: 746-753
  • 6 Chmielewski TL, Zeppieri Jr G, Lentz TA, Tillman SM, Moser MW, Indelicato PA, George SZ. Longitudinal changes in psychosocial factors and their association with knee pain and function after anterior cruciate ligament reconstruction. Phys Ther 2011; 91: 1355-1366
  • 7 Cole LJ, Farrell MJ, Gibson SJ, Egan GF. Age-related differences in pain sensitivity and regional brain activity evoked by noxious pressure. Neurobiol Aging 2008; 31: 494-503
  • 8 D’Eon JL, Harris CA, Ellis JA. Testing factorial validity and gender invariance of the pain catastrophizing scale. J Behav Med 2004; 27: 361-372
  • 9 Dannecker EA, Gagnon CM, Jump RL, Brown JL, Robinson ME. Self-care behaviors for muscle pain. J Pain 2004; 5: 521-527
  • 10 Dannecker EA, Knoll V, Robinson ME. Sex differences in muscle pain: self-care behaviors and effects on daily activities. J Pain 2008; 9: 200-209
  • 11 Dick R, Sauers EL, Agel J, Keuter G, Marshall SW, McCarty K, McFarland E. Descriptive epidemiology of collegiate men’s baseball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train 2007; 42: 183-193
  • 12 Doherty TJ. The influence of aging and sex on skeletal muscle mass and strength. Curr Opin Clin Nutr Metab Care 2001; 4: 503-508
  • 13 George SZ, Dover GC, Fillingim RB. Fear of pain influences outcomes after exercise-induced delayed onset muscle soreness at the shoulder. Clin J Pain 2007; 23: 76-84
  • 14 George SZ, Dover GC, Wallace MR, Sack BK, Herbstman DM, Aydog E, Fillingim RB. Biopsychosocial influence on exercise-induced delayed onset muscle soreness at the shoulder: pain catastrophizing and catechol-o-methyltransferase (COMT) diplotype predict pain ratings. Clin J Pain 2008; 24: 793-801
  • 15 George SZ, Hirsh AT. Psychologic influence on experimental pain sensitivity and clinical pain intensity for patients with shoulder pain. J Pain 2009; 10: 293-299
  • 16 George SZ, Wallace MR, Wright TW, Moser MW, Greenfield 3rd WH, Sack BK, Herbstman DM, Fillingim RB. Evidence for a biopsychosocial influence on shoulder pain: pain catastrophizing and catechol-O-methyltransferase (COMT) diplotype predict clinical pain ratings. Pain 2008; 136: 53-61
  • 17 Glazer DD. Development and preliminary validation of the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale. J Athl Train 2009; 44: 185-189
  • 18 Gummesson C, Ward MM, Atroshi I. The shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH): validity and reliability based on responses within the full - length DASH. BMC Musculoskelet Disord 2006; 7: 44
  • 19 Harriss DJ, Atkinson G. Update – Ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
  • 20 Hirsh AT, George SZ, Bialosky JE, Robinson ME. Fear of pain, pain catastrophizing, and acute pain perception: relative prediction and timing of assessment. J Pain 2008; 9: 806-812
  • 21 Jones A, Zachariae R. Gender, anxiety, and experimental pain sensitivity: an overview. J Am Med Womens Assoc 2002; 57: 91-94
  • 22 Kaplan LD, Flanigan DC, Norwig J, Jost P, Bradley J. Prevalence and variance of shoulder injuries in elite collegiate football players. Am J Sports Med 2005; 33: 1142-1146
  • 23 Keller S, Bann CM, Dodd SL, Schein J, Mendoza TR, Cleeland CS. Validity of the brief pain inventory for use in documenting the outcomes of patients with noncancer pain. Clin J Pain 2004; 20: 309-318
  • 24 Keogh E, Book K, Thomas J, Giddins G, Eccleston C. Predicting pain and disability in patients with hand fractures: comparing pain anxiety, anxiety sensitivity and pain catastrophizing. Eur J Pain 2009; 14: 446-451
  • 25 Langford JL, Webster KE, Feller JA. A prospective longitudinal study to assess psychological changes following anterior cruciate ligament reconstruction surgery. Br J Sports Med 2009; 43: 377-378
  • 26 Leeuw M, Goossens ME, Linton SJ, Crombez G, Boersma K, Vlaeyen JW. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med 2007; 30: 77-94
  • 27 Marshall SW, Hamstra-Wright KL, Dick R, Grove KA, Agel J. Descriptive epidemiology of collegiate women's softball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988–1989 through 2003–2004. J Athl Train 2007; 42: 286-294
  • 28 McNeil DW, Rainwater 3rd AJ. Development of the Fear of Pain Questionnaire--III. J Behav Med 1998; 21: 389-410
  • 29 Meulders A, Vansteenwegen D, Vlaeyen JW. Women, but not men, report increasingly more pain during repeated (un)predictable painful electrocutaneous stimulation: evidence for mediation by fear of pain. Pain 2012; 153: 1030-1041
  • 30 Niven A, Nevill A, Sayers F, Cullen M. Predictors of rehabilitation intention and behavior following anterior cruciate ligament surgery: an application of the Theory of Planned Behavior. Scand J Med Sci Sports 2012; 22: 316-322
  • 31 Nosaka K, Newton M. Is recovery from muscle damage retarded by a subsequent bout of eccentric exercise inducing larger decreases in force?. J Sci Med Sport 2002; 5: 204-218
  • 32 Nosaka K, Newton M, Sacco P. Delayed-onset muscle soreness does not reflect the magnitude of eccentric exercise-induced muscle damage. Scand J Med Sci Sports 2002; 12: 337-346
  • 33 Osman A, Barrios FX, Gutierrez PM, Kopper BA, Merrifield T, Grittmann L. The Pain Catastrophizing Scale: further psychometric evaluation with adult samples. J Behav Med 2000; 23: 351-365
  • 34 Parr JJ, Borsa PA, Fillingim RB, Tillman MD, Manini TM, Gregory CM, George SZ. Pain-related fear and catastrophizing predict pain intensity and disability independently using an induced muscle jnjury model. J Pain 2012; 13: 370-378
  • 35 Parr JJ, Yarrow JF, Garbo CM, Borsa PA. Symptomatic and functional responses to concentric-eccentric isokinetic versus eccentric-only isotonic exercise. J Athl Train 2009; 44: 462-468
  • 36 Plotnikoff NA, MacIntyre DL. Test-retest reliability of glenohumeral internal and external rotator strength. Clin J Sport Med 2002; 12: 367-372
  • 37 Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State and Trait Anxiety Inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press; 1983
  • 38 Sullivan M, Bishop S, Pivik J. The Pain Catastrophizing Scale: Development and Validation. Psychology 1995; 7: 524-532
  • 39 Sullivan MJ, Rodgers WM, Wilson PM, Bell GJ, Murray TC, Fraser SN. An experimental investigation of the relation between catastrophizing and activity intolerance. Pain 2002; 100: 47-53
  • 40 Swinkels-Meewisse IE, Roelofs J, Oostendorp RA, Verbeek AL, Vlaeyen JW. Acute low back pain: pain-related fear and pain catastrophizing influence physical performance and perceived disability. Pain 2006; 120: 36-43
  • 41 Tis LL, Maxwell T. The effect of positioning on shoulder isokinetic measures in females. Med Sci Sports Exerc 1996; 28: 1188-1192
  • 42 Woby SR, Roach NK, Urmston M, Watson PJ. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain 2005; 117: 137-144