The objective was to study prevalence and underlying pathology of "swimmer's shoulder".
Twenty-two competitive swimmers of national "D-Kader" (elite development swimmers)
were evaluated by means of questionnaire, clinical examination and isokinetic testing
of external rotation and internal rotation. At the examination current interfering
pain necessitating a cessation or reduction of practice was found in 5 (23 %) athletes.
At isokinetic testing 8 (36 %) athletes complained of shoulder pain. Any history of
pain was seen in 14 (64 %) swimmers. A positive impingement sign was noted in 11 (50
%) athletes. Apprehension sign which is indicative of anterior instability was found
in 11 (50 %) swimmers. Clinical equivalents of dysfunction of scapulothoracic muscles
such as scapular winging (5 athletes) and shoulder protraction (12 athletes) were
noted. For comparison of results of isokinetic testing a control group of non-swimmers
was selected matching the group of swimmers exactly in terms of age, sex and dominant
side. External rotation/internal rotation ratio of peak torque and total work at 60
deg/sec and 180 deg/sec was significantly lower in swimmers than in controls. The
ratio was independent of sex, dominant side, history of pain and pain at examination.
During internal rotation competitive swimmers produced significantly higher peak torques
and total work than controls. There was no significant difference in external rotation.
In conclusion there are several different abnormalities of function contributing to
the pathology of "swimmer's shoulder":- Laxity of anterior-inferior capsuloligamentous
structures with atruamatic anterior instability due to repetitive overload. - Impingement
with rotator cuff tendinitis. - Muscular imbalance of the rotator cuff muscles and
scapulothoracic dysfunction.
Key words
Swimming - swimmer's shoulder - impingement - anterior instability - muscular imbalance
