Natural History of Shoulder Pathology in Manual Wheelchair Users

Inclusion Criteria: Group1 (Manual Wheelchair User Cohort): * Participants with traumatic or non-traumatic spinal cord injury who have begun using a MWC within 12 months of enrollment * 18 - 70 years of age * Use of a manual wheelchair as the primary mode of mobility * Functional upper extremity range of motion * Willingness to participate in study * Ability to return to receive shoulder MRI 1-3 times/year , and once per year receive physical exam, and strength assessments. Group 2 (Matched Able-bodied Cohort): * 18-70 years of age * Able to walk independently with no reliance on an orthotic, prosthetic, or gait aid * Functional upper extremity range of motion * Willingness to participate in study * Ability to receive shoulder MRI 1-3 times/year, and once per year receive physical exam, and strength assessments. Exclusion Criteria: Group1 (Manual Wheelchair User Cohort): • Previous diagnosis of bilateral shoulder tendon tears prior to spinal cord injury or suspected tendon tears with physical exam Group 2 (Matched Able-bodied Cohort): * Any documented musculoskeletal or neurological disorders that would be expected to impact shoulder health or change ability to walk independently * Previous diagnosis of shoulder tears prior to enrollment or suspected tendon tears with physical exam