Open Access Research article

High-resolution ultrasound of rotator cuff and biceps reflection pulley in non-elite junior tennis players: anatomical study

Alberto Tagliafico1, Angela Cadoni1, Bianca Bignotti2* and Carlo Martinoli2

Author Affiliations

1 Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Via de Toni 14, 16132 Genoa, Italy

2 Radiology Department -DISSAL- Università di Genova, Largo Rosanna Benzi 8, 16138 Genova, Italy

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BMC Musculoskeletal Disorders 2014, 15:241  doi:10.1186/1471-2474-15-241

Published: 18 July 2014



Tennis is believed to be potentially harmful for the shoulder, therefore the purpose of this study is to evaluate the anatomy of the rotator cuff and the coraco-humeral ligament (CHL) in a-symptomatic non-elite junior tennis players with high-resolution ultrasound (US).


From August 2009 to September 2010 n = 90 a-symptomatic non-elite junior tennis players (mean age ± standard deviation: 15 ± 3) and a control group of age- and sex- matched subjects were included. Shoulder assessment with a customized standardized protocol was performed. Body mass index, dominant arm, years of practice, weekly hours of training, racket weight, grip (Eastern, Western and semi-Western), kind of strings were recorded.


Abnormalities were found at ultrasound in 14/90 (15%) players. Two players had supraspinatus tendinosis, two had subacromial impingement and ten had subacromial bursitis. CHL thickness resulted comparable in the dominant and non-dominant arms (11.3 ± 4.4 mm vs. 13 ± 4.2, p > 0.05). Multivariate analysis demonstrated that no association was present among CHL thickness and the variables evaluated. In the control group, abnormalities were found at ultrasound in 6/60 (10%) subjects (sub-acromial bursitis). No statistically significant differences between players and control group were found (p = 0.71).


In a-symptomatic non-elite junior tennis players only minor shoulder abnormalities were found.

Shoulder; Ultrasound; Tennis; Biceps; Bursitis