Is suprascapular neuropathy common in high-performance beach volleyball players? A retrospective analysis

Published on September 6, 2014 by Pieber K, Herceg M, Fialka C, Oberleitner G, Gruther W, Paternostro-Sluga T

Key Takeaway

Muscle atrophy in elite beach volleyball players may stem from biomechanical factors rather than true suprascapular neuropathy, as electrophysiological testing of symptomatic athletes showed no nerve lesions.

Pieber K., Herceg M., Fialka C., Oberleitner G., Gruther W., Paternostro-Sluga T.. (2014). Is suprascapular neuropathy common in high-performance beach volleyball players? A retrospective analysis. https://doi.org/10.1007/s00508-014-0595-4

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What this study found

In this retrospective cross-sectional study, researchers evaluated 18 high-performance beach volleyball players using electrophysiological testing to investigate the prevalence of suprascapular neuropathy. Although five players presented visible atrophy of the muscles innervated by the suprascapular nerve, none of the participants showed electrophysiological evidence of acute or chronic nerve lesions on nerve conduction studies or needle electromyography (EMG).

Why it matters

Shoulder pain and isolated wasting of the infraspinatus or supraspinatus muscles are common in overhead athletes. Clinicians frequently attribute these symptoms to suprascapular nerve entrapment. However, these findings suggest that muscle atrophy in elite athletes may often be biomechanical rather than neurogenic in origin. Potential non-neuropathic mechanisms include:

  • Repetitive microtrauma and eccentric overload during the deceleration phase of serving and spiking.
  • Scapular dyskinesis leading to altered muscle activation patterns and subsequent disuse atrophy.
  • Inhibition of the infraspinatus muscle due to underlying intra-articular pathology, such as labral tears.

For physical medicine and rehabilitation clinicians, this underscores the necessity of objective electrodiagnostic testing before diagnosing nerve compression. It also supports prioritizing conservative, biomechanically-focused rehabilitation—targeting scapular stability and rotator cuff balance—over invasive surgical decompression.

Limitations

The primary limitations of this study are its retrospective design and small sample size of 18 players. Furthermore, static electrophysiological testing may not capture transient, dynamic nerve compression that occurs exclusively during high-velocity overhead athletic maneuvers.

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