Altered Functional and Structural Measures in Masters Swimmers With Shoulder Pain and Disability

Abstract

Context: Supraspinatus tendinopathy and shoulder pain are common in competitive youth swimmers; however, no studies have investigated clinical and structural factors contributing to shoulder pain and disability in master level swimmers. Objective: The objectives of this study were: 1) to determine the prevalence of shoulder pain and disability in master level swimmers, 2) to identify the most provocative special tests for shoulder pain, and 3) to determine if shoulder clinical and tissue specific measures, training variables and volume vary between those with and without shoulder pain, dissatisfaction and disability. Design: Cross-sectional. Setting: Collegiate swimming facilities. Patients or Other Participants: Thirty-nine adult masters level swimmers were evaluated and included in the data analysis. Main Outcome Measures: A survey of demographics, training, and pain and disability ratings using the Penn Shoulder Score and Disability of Arm Shoulder Hand sports module. Swimmers underwent a clinical exam including shoulder passive range of motion (PROM), posterior shoulder endurance test (PSET), supraspinatus tendon structure and posterior capsule thickness. One-way ANOVAs were used to compare demographics, clinical and structural findings between those with significant pain, dissatisfaction and disability (+PDD) and those without (−PDD). Results: Fifteen percent of subjects reported pain at rest, 28% with normal activities (eating, dressing), and 69% with strenuous activities (sports) and 50% reported disability. The +PDD group had less shoulder internal rotation (10°), less ER (8°), and completed less yardage per day and per year. There were significant differences in the supraspinatus tendon structure between the +PDD and –PDD groups. Conclusion: Masters swimmers with pain and disability are able to self-limit yardage and likely why they recorded less yardage. The reduced shoulder motion (IR and ER) without posterior capsule differences may be due to rotator cuff muscle/tendon restrictions and the supraspinatus tendon structure may indicate degeneration caused by previous overuse resulting in pain.

Therapeutic Effectiveness of Postural Treatment on Youth Swimmers’ Anterior Shoulder Pain—An Interventional Study

“…These findings align with previous research, which has reported a wide range in the prevalence of shoulder pain among swimmers, ranging from 35% to 91%. Several publications [4][5][6][10][11][12]14,15] have indicated that shoulder pain in swimmers is a complex condition with multiple contributing factors, although the primary cause is believed to be the repetitive overhead motion involved in swimming [9] . When considering factors that contribute to the development of shoulder pain in adolescent competitive swimmers, it is crucial to examine their habitual posture.…”

“…This symptom is often referred to as "swimmer's shoulder", which describes anterior shoulder pain caused by dysfunction, but does not define a specific clinical diagnosis [2] (. According to the current literature, the prevalence of this phenomenon is very high in adult [3][4][5][6] and young [2,7,8] competitive swimmers, ranging from 35% to 91% depending on age, gender, and training volume, and the first painful event may occur as early as 11 to 13 years of age [7]. Although highly repetitive overhead strokes (e.g., freestyle swimming, [9], up to 2500/day and 16,000/week, are the primary cause [6,10], shoulder mobility, force imbalances, and static or dynamic postural abnormalities [4][5][6][11][12][13][14][15] could also contribute to pain.…”

“…According to the current literature, the prevalence of this phenomenon is very high in adult [3][4][5][6] and young [2,7,8] competitive swimmers, ranging from 35% to 91% depending on age, gender, and training volume, and the first painful event may occur as early as 11 to 13 years of age [7]. Although highly repetitive overhead strokes (e.g., freestyle swimming, [9], up to 2500/day and 16,000/week, are the primary cause [6,10], shoulder mobility, force imbalances, and static or dynamic postural abnormalities [4][5][6][11][12][13][14][15] could also contribute to pain. Common postural abnormalities in swimmers take the form of the more typical "swimmer's posture", described as a forward leaning head posture, increased thoracic kyphosis and protracted shoulder girdle [14,16,17] Good posture refers to the natural and balanced maintenance of various parts of the body [18] Its importance in sport is that athletes with poor posture are exposed to a greater risk of injury due to altered joint positions and established muscle imbalance.…”

Disability Associated with Shoulder Pain during Life Span of Competitive Swimmers; A Cross-sectional study

“…4 Discussing the results of the current study, coincide with the findings given for reduced shoulder motion in the study by Stephen J. Thomas and his team. 6 The reduction in the shoulder motion, internal and external rotation, might be due to rotator cuff degeneration or overuse and thus resulted in pain and reduced level of satisfaction of shoulder functioning in swimmers. 6,25 A study showed results between disability and pain which coincides with a study by Tate and his team.…”

“…4,5 Shoulder pain, discomfort and supraspinatus tendinopathy are communal in competitive swimmers. 6 Pain and discomfort are the main symptoms after orthopedic injury in these swimmers. 7,8 The chief cause of pain and discomfort in the shoulder is glenohumeral slackness, impingement disorder and rotator cuff or biceps injury.…”