Altered Functional and Structural Measures in Masters Swimmers With Shoulder Pain and Disability
Stephen J Thomas1, Anthony Blubello2, Alyssa Peterson3
1Thomas Jefferson University, Philadelphia, PA.
Context:
Supraspinatus tendinopathy and shoulder pain are common in competitive youth swimmers. However, no researchers have investigated clinical and structural factors contributing to shoulder pain and disability in masters-level swimmers.
Objective:
To (1) determine the prevalence of shoulder pain and disability in masters-level swimmers; (2) identify the most provocative special tests for shoulder pain; and (3) determine if shoulder clinical and tissue-specific measures, training variables, and volume varied between those with and those without shoulder pain, dissatisfaction, and disability.
Design:
Cross-sectional study.
Setting:
Collegiate swimming facilities.
Patients Or Other Participants:
Thirty-nine adult masters-level swimmers.
Main Outcome Measures:
Demographics, training, and pain and disability ratings using the Penn Shoulder Score and Disability of Arm, Shoulder, and Hand sports module were surveyed. Swimmers underwent a clinical examination that consisted of passive range of shoulder motion, posterior shoulder endurance test, and supraspinatus tendon structure and posterior capsule thickness. One-way analyses of variance were used to compare demographic, clinical, and structural findings between those with significant (positive) pain, dissatisfaction, and disability (+PDD) and those without (negative) pain, dissatisfaction, and disability (-PDD).
Results:
Pain was reported by 15% of participants at rest, 28% with normal activities (eating, dressing), and 69% with strenuous activities (sports); 50% reported disability. The +PDD group had less shoulder internal rotation (10°) and less external rotation (8°) and completed less yardage per day and per year. Differences were noted in supraspinatus tendon structure between the +PDD and -PDD groups.
Conclusions:
Masters swimmers with pain and disability were able to self-limit yardage, which was likely the reason they recorded less yardage. The reduced shoulder motion (internal and external rotation) without posterior capsule differences may be due to rotator cuff muscle and tendon restrictions; the supraspinatus tendon structure may reflect degeneration caused by previous overuse that resulted in pain.
