Prevalence of Rotator Cuff Injuries Among Provincial-Level Athletes in Balochistan and KP

Abstract

Background:
Rotator cuff (RC) injuries are a leading cause of shoulder dysfunction among athletes, particularly those engaged in overhead sports. Despite growing global awareness of sports-related shoulder pathology, data from developing regions such as Balochistan and Khyber Pakhtunkhwa (KP) remain scarce. Understanding the prevalence and characteristics of RC injuries in these populations is essential for guiding preventive and rehabilitative strategies in sports medicine.

Objective:
To determine the prevalence and characteristics of rotator cuff injuries among provincial-level athletes in Balochistan and KP, and to identify associations with sport type, training duration, and load exposure.

Methods:
A cross-sectional study was conducted in private hospitals and sports rehabilitation centers in Quetta and Peshawar. A total of 412 provincial-level athletes aged 18–40 years were evaluated through standardized clinical examination and diagnostic shoulder ultrasound. Inclusion criteria required active participation in organized sport within the previous 12 months. Data were analyzed using SPSS v26, applying chi-squared and t-tests, with p < 0.05 considered significant. Ethical approval was obtained from the institutional review board, and informed consent was secured from all participants.

Results:
Ultrasound revealed RC pathology in 158 athletes (38.3%). Tendinopathy was observed in 22.8%, partial-thickness tears in 10.2%, and full-thickness tears in 5.3%. Overhead athletes showed a significantly higher prevalence (48.9%) than non-overhead athletes (30.5%) (p < 0.001). RC injury was positively associated with older age, longer training duration, and greater weekly training hours. Notably, 61.4% of affected athletes were asymptomatic at the time of assessment.

Conclusion:
Rotator cuff pathology is common among provincial-level athletes in Balochistan and KP, with a high proportion of subclinical cases. Early screening, preventive physiotherapy, and training load management should be prioritized to reduce long-term morbidity and enhance athletic performance.

Keywords:
Athletes; Cross-Sectional Studies; Epidemiology; Khyber Pakhtunkhwa; Prevalence; Rotator Cuff Injuries; Shoulder Pain; Sports Medicine