Identifying the Most Susceptible Rotator Cuff Muscle in Amateur Boxers: A Cross-Sectional Study

Abstract

Background: Rotator cuff injuries are prevalent in overhead and contact sports like boxing, where repetitive upper limb movements lead to overuse and trauma-related pathologies. Objective: To identify the most commonly affected rotator cuff muscle among amateur boxers using clinical functional assessment. Methods: This cross-sectional study included 184 amateur boxers aged 18–30 years from UFC gyms and university sports departments in Lahore, Pakistan. Participants had at least two years of consistent boxing experience. The American Shoulder and Elbow Surgeons (ASES) questionnaire was administered to assess shoulder pain and function. Physical assessments included the Drop Arm Test, Infraspinatus Test, Hornblower’s Sign, and Gerber’s Lift-Off Test, each targeting a specific rotator cuff muscle. Sensitivity and specificity of each test were considered. Descriptive statistics were performed using SPSS v25. Results: Out of 184 boxers, 152 were male (82.6%) and 32 female (17.4%), with a mean age of 22.98 ± 3.51 years. Supraspinatus was the most affected muscle, with 72 participants (39.1%) testing positive via Drop Arm Test. Infraspinatus, subscapularis, and teres minor followed with 38.0%, 36.9%, and 26.1% involvement, respectively. Moderate to severe shoulder pain was reported by 77.2% of boxers. Conclusion: Supraspinatus tears are the most prevalent rotator cuff injury in amateur boxers, emphasizing the need for early screening, preventive rehabilitation, and shoulder-strengthening protocols in boxing training programs. Keywords: Athletic Injuries, Boxing, Pain Measurement, Physical Examination, Rotator Cuff Injuries, Shoulder Impingement Syndrome, Shoulder Injuries, Shoulder Joint, Sports, Supraspinatus, Tears