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Shoulder Injuries in Competitive Swimming.

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Shoulder Injuries in Competitive Swimming Shoulder pain is a common problem among competitive swimmers and often limits their ability to train and compete. Swimming places an extreme demand upon the shoulder complex. There are many terms used to describe the shoulder pain identified with competitive swimming such as swimmer's shoulder, impingement, shoulder instability, or rotator cuff tendinitis. Studies of active swimmers have shown that the incidence of shoulder pain interferes with training or competition and overuse appears to be a major contributor to this problem. Excessive training demands, the level of competition and length of participation have been demonstrated to correlate with the occurrence of shoulder pain. Although reports of swimmer's shoulder have become increasingly evident and the complexities of shoulder injuries have become more understood, there is no uniform approach to its management. Swimming repeatedly stresses the complex shoulder joint. The shoulder's range of motion in multiple directions requires a degree of instability and little bony support. For stability, the shoulder relies on the capsule, the rotator cuff muscles and the larger surrounding muscles such as the pecotoralis major, the deltoids, the serratus anterior and the long head of the biceps. The scapula is mobile and is the base of the glenohumeral joint, which must be controlled for proper shoulder function. The rhomboids, serratus anterior and trapezius muscles are the main scapular stabilizers in swimming (McMaster, 1999). Impingement occurs when the soft tissues of the subacromial space are compressed between the head of the humerus and the coracoacromial arch and anterior acromion (Johnson, Gauvin, & Fredericson, 2003). ...read more.


The survey revealed common responses for training activities that aggravated current shoulder pain such as stretching, tubing resistance exercises, kicking drills using flotation boards, weight training and hand paddles. The results of this study showed that as the skill level and age of swimmers increases so did the percentage afflicted with interfering shoulder pain (McMaster & Troup, 1993). This may indicate that the more training a swimmer has undergone, the likelihood to develop a shoulder injury increases. Although a number of rehabilitation programs for swimmer's shoulder have been reported in literature nonoperative treatment has generally been favored. A case study was conducted on the effectiveness of treatment interventions and the in-season management of a NCAA Division I swimmer with unilateral shoulder pain. The 22-year-old swimmer had a history of left shoulder pain and was diagnosed with tendonitis of the long head of the left bicep. It was from the clinical assessment that a direct treatment was generated. The author hypothesized that the athlete had anteriorly subluxed her shoulder and developed rotator cuff tendonitis from overusing the rotator cuff to stabilize the humeral head (Russ, 1998). The treatment approach was team coordinated and used previously prescribed protocols such as medication and physical therapy, as well as the adding and elimination of different exercises. Exercises to strengthen the scapular stabilizer muscles in order to facilitate cocontraction around the glenohumeral joint were substituted for the athlete's previous dumbbell exercises for external rotation and cardinal plane flexion and abduction. Also part of treatment was a rest period for the irritated cuff musculature and strengthening of the scapular stabilizers. ...read more.


Through out the six week training period an athletic trainer recorded the incidence of injury for both the experimental and control groups. The athletes that where experiencing shoulder pain continued with only the lower body training and kicked with their arms by their side during pool training until the athlete was without pain above 90� of shoulder abduction. The functional training program carried out by the experimental group was performed three days a week for six weeks in a row. The program consisted of seven exercises, four of which used elastic -tubing, two where prone exercises utilizing free weights for resistance and the last exercise was a push-up-plus. There was no significant difference between the groups but a significant difference within-group increases (Swanik et al., 2002). The results of this study suggest that incorporating functional training exercises into the swimming season could decrease the incidence of shoulder pain. The shoulder is injuries in competitive swimmers have individual circumstance which bring forth unique problems. There is a need for further research investigating the cause of swimming related shoulder problems specifically related to stroke mechanics and overuse. In order to prevent the muscoloskeltal injuries the area of causation needs to be targeted. Training methods for the shoulder complex of the swimmer also needs further research in order to prevent any subsequent training injuries. Keeping the swimmer in the water is a crucial component to a successful season. Good communication among the swimmer, coach, athletic trainer, and physical therapist are key in rehabilitating the injured swimmer. Each individual case may vary and the communication between the athlete and all persons involved are critical when implementing a prevention or rehabilitation for swimming related shoulder injuries. ...read more.

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