Matsuura Yuiko, Fujimoto Tomomi, Koizumi Keisuke, Mise Takao, Edama Mutsuaki, Shimoyama Yoshimitsu
Department of Health and Sports, Niigata University of Health and Welfare, Japan.
Department of Health and Sports, Niigata University of Health and Welfare, Japan.
J Sci Med Sport. 2023 Dec;26(12):694-699. doi: 10.1016/j.jsams.2023.09.019. Epub 2023 Oct 5.
To identify factors associated with shoulder pain in swimmers based on elastic muscle modulus, joint range of motion, and isometric muscle strength.
Cohort study.
Forty-eight competitive swimmers without shoulder pain (age: 18-28 years; men: 29) were followed-up for 6 months. Baseline measurements of the elastic modulus of the pectoralis minor, supraspinatus, infraspinatus, posterior deltoid, and pectoralis minor muscles were obtained using shear wave elastography. Range of motion and isometric strength were measured using a goniometer and a hand-held dynamometer, respectively. A questionnaire was administered weekly for 6 months to determine shoulder pain occurrence. Each item was compared between shoulders with and without pain at baseline. For participants with shoulder pain exceeding 2 weeks, shear wave elastography and range of motion at baseline (pre pain) and during follow-up (post pain) were compared.
Of 46 swimmers followed-up for 6 months, 20 reported shoulder pain. 14 swimmers with pain were evaluated twice. Participants with shoulder pain during follow-up had significantly higher posterior deltoid and pectoralis minor stiffness at baseline and high lower extremity isometric muscle strength contralateral to the shoulder with pain compared to those without pain (p < 0.05). Swimmers with pain exceeding 2 weeks exhibited no differences in ultrasound shear wave elastography and range of motion at baseline and after pain onset.
Posterior deltoid and pectoralis minor muscle stiffness, and high isometric lower extremity strength contralateral to the shoulder with pain may be associated with shoulder pain development, thereby indicating the importance of maintaining posterior deltoid and pectoralis minor muscle flexibility during conditioning.
基于弹性肌肉模量、关节活动范围和等长肌力，确定与游泳运动员肩部疼痛相关的因素。
队列研究。
对48名无肩部疼痛的竞技游泳运动员（年龄：18 - 28岁；男性：29名）进行了6个月的随访。使用剪切波弹性成像技术获取胸小肌、冈上肌、冈下肌、三角肌后束和胸小肌的弹性模量基线测量值。分别使用角度计和手持测力计测量活动范围和等长肌力。在6个月内每周进行一次问卷调查，以确定肩部疼痛的发生情况。对基线时有无疼痛的肩部各项指标进行比较。对于肩部疼痛超过2周的参与者，比较其基线时（疼痛前）和随访期间（疼痛后）的剪切波弹性成像和活动范围。
在46名接受了6个月随访的游泳运动员中，20名报告有肩部疼痛。对14名疼痛的游泳运动员进行了两次评估。与无疼痛的运动员相比，随访期间有肩部疼痛的参与者在基线时三角肌后束和胸小肌的僵硬度显著更高，且疼痛肩部对侧的下肢等长肌力较高（p < 0.05）。疼痛超过2周的游泳运动员在基线时和疼痛发作后，超声剪切波弹性成像和活动范围没有差异。
三角肌后束和胸小肌的肌肉僵硬度，以及疼痛肩部对侧较高的下肢等长肌力可能与肩部疼痛的发生有关，从而表明在训练过程中保持三角肌后束和胸小肌灵活性的重要性。
