Can scapular and humeral head position predict shoulder pain in adolescent swimmers and non-swimmers?

Abstract

The aims of this study were to determine whether scapular and humeral head position can predict the development of shoulder pain in swimmers, whether those predictors were applicable to non-swimmers and the annual rate of shoulder pain in adolescent swimmers and non-swimmers. Forty-six adolescent swimmers and 43 adolescent non-swimmers were examined prospectively with a questionnaire and anthropometric measures. The questionnaire examined demographic and training variables. Anthropometric measures examined the distances between the T7 spinous process and the inferior scapula (Inferior Kibler) and T3 spinous process and the medial spine of the scapula (Superior Kibler), humeral head position in relation to the acromion using palpation, BMI and chest width. Shoulder pain was re-assessed 12 months later by questionnaire. Shoulder pain in swimmers was best predicted by a larger BMI (OR = 1.48, P = 0.049), a smaller Inferior Kibler distance in abduction (e.g. OR = 0.90, P = 0.009) and a smaller horizontal distance between the anterior humeral head and the anterior acromion (OR = 0.76, P = 0.035). These variables were not significantly predictive of shoulder pain in non-swimmers. Annual prevalence of shoulder pain was 23.9% in swimmers and 30.8% in non-swimmers (χ(2) = 0.50, P = 0.478).

Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis

“…Where a study used multiple classifications, this was dichotomised into with or without scapular dyskinesis for meta-analysis 24 36 37. Only one study differed substantially from these methods of visual classification, using measurement of distance between anatomical landmarks 35. The author of that study provided dichotomised data (with or without scapular dyskinesis) using receiver operating characteristic analysis.…”

“…The results of this sensitivity analysis demonstrated that the presence of scapular dyskinesis at baseline was indicative of a 54% increased risk of shoulder pain (RR=1.54, 95% CI 1.13 to 2.10, I 2 =40%). To determine the effects of a different assessment of scapular dyskinesis, McKenna et al 35 was excluded. The results of this sensitivity analysis demonstrated that the presence of scapular dyskinesis at baseline was indicative of a 28% increased risk of shoulder pain (RR=1.28, CI 0.93 to 1.76, I 2 =17%).…”

“…Measurement of scapular dyskinesis varied, as one included study35 reported scapular dyskinesis using continuous data, which required dichotomisation for the current meta-analysis. A sensitivity analysis excluding this study highlighted homogeneity among the remaining four studies (I 2 =17%) 24 34 36 37.…”

Musculoskeletal dysfunctions associated with swimmers’ shoulder

“…A prospective study by Mckenna et al 7 investigated whether humeral head position is predictive of the development of shoulder pain in competitive swimmers. They studied 46 adolescent swimmers.…”

“…Rates vary, depending on age, level of competition, swim stroke, amount of training, time of season and the definition of shoulder pain. Symptoms may begin at an early age, with 21% of swimmers aged 8–11 reporting significant pain, but high school swimmers were found to be the most symptomatic age category 6 7. A belief even exists that shoulder pain is normal and should be tolerated to complete practice 8.…”