Thomas Stephen J, Blubello Anthony, Peterson Alyssa, Blum David, Sarver Joseph J, Cobb Justin, Tate Angela R
Thomas Jefferson University, Philadelphia, PA.
Tactical Fitness and Performance, Warwick, RI.
J Athl Train. 2021 Apr 13;56(12):1313-20. doi: 10.4085/1062-6050-0067.21.
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.
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.
Cross-sectional.
Collegiate swimming facilities.
Thirty-nine adult masters level swimmers were evaluated and included in the data analysis.
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).
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.
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.
冈上肌腱病和肩部疼痛在青少年竞技游泳运动员中很常见；然而，尚无研究调查导致成年游泳运动员肩部疼痛和功能障碍的临床和结构因素。
本研究的目的是：1）确定成年游泳运动员肩部疼痛和功能障碍的患病率，2）确定引发肩部疼痛的最具激发性的特殊检查，3）确定肩部临床和组织特异性测量、训练变量和训练量在有或没有肩部疼痛、功能障碍和不满的运动员之间是否存在差异。
横断面研究。
大学游泳设施。
39名成年游泳运动员接受评估并纳入数据分析。
使用宾夕法尼亚肩部评分和手臂、肩部和手部运动功能障碍模块对人口统计学、训练情况以及疼痛和功能障碍评分进行调查。游泳运动员接受临床检查，包括肩部被动活动范围（PROM）、肩部后伸耐力测试（PSET）、冈上肌腱结构和后关节囊厚度。采用单因素方差分析比较有明显疼痛、功能障碍和不满（+PDD）与无上述情况（-PDD）的运动员之间的人口统计学、临床和结构检查结果。
15%的受试者报告休息时疼痛，28%在进行正常活动（进食、穿衣）时疼痛，69%在进行剧烈活动（运动）时疼痛，50%报告有功能障碍。+PDD组的肩部内旋角度较小（10°），外旋角度较小（8°），每天和每年的训练量较少。+PDD组和-PDD组之间的冈上肌腱结构存在显著差异。
有疼痛和功能障碍的成年游泳运动员能够自我限制训练量，这可能是他们训练量较少的原因。肩部活动度降低（内旋和外旋）但后关节囊无差异可能是由于肩袖肌肉/肌腱受限，冈上肌腱结构可能表明既往过度使用导致退变并引起疼痛。
