Does an Increase in Supraspinatus Tendon Thickness After Swimming Increase the Likelihood of Future Shoulder Pain?

Abstract

Background

Increase in supraspinatus tendon thickness (STT) resulting from swimming practice has been observed in those with a history of shoulder pain. The magnitude of change in STT after a swimming session and its rate of recovery may be an indicator of future shoulder pain incidence.

Hypothesis

The supraspinatus tendons that demonstrate a greater increase in thickness as a result of swimming practice will have an increased likelihood of future shoulder pain in a cohort of competitive swimmers over a period of 6 months.

Design

Descriptive epidemiology study.

Level of Evidence:

Level 2b, individual cohort studies.

Methods:

A cohort of 50 nationally qualified swimmers aged between 14 and 22 years, from 3 open National Swimming Programs in Victoria, Australia, were recruited for this study. Ultrasonographic measurements of swimmers’ STT was obtained of both shoulders, before, immediately after, and 6 hours after a single swimming practice session. Data were recorded of any significant interfering shoulder pain at 3 and 6 months after the initial testing session.

Results

Stepwise logistic regression models indicated that significant predictors of the likelihood of experiencing significant interfering pain were sex [significant at 6 months; odds ratio (OR) 4.2] and the extent of change in STT immediately (OR 2.3 and 1.3 per mm at 3 and 6 months, respectively) and 6 hours postpractice (OR 1.9 and 1.5 per mm at 3 and 6 months, respectively).

Conclusion

The current data suggest larger increases in tendon thickness after training are associated with an increased likelihood of future shoulder pain.

Clinical Relevance

These data may be valuable for monitoring training load and identifying athletes who may have an increased likelihood of shoulder pain.

Keywords

ultrasound shoulder supraspinatus tendon swimming injury

Get full access to this article

View all access options for this article.

References

Boettcher

. Rotating our approach - hand held dynamometry and swimmers shoulder. Sport Physio. 2013;2.

Ciullo

J V

Stevens

. The prevention and treatment of injuries to the shoulder in swimming. Sports Med. 1989;7(3):182-204.

Docking

Girdwood

Cook

Fortington

Rio

. Reduced levels of aligned fibrillar structure are not associated with Achilles and patellar tendon symptoms. Clin J Sport Med. 2020;30(6):550-555.

Dutton

Tam

Brown

Gray

. The cricketer's shoulder: not a classic throwing shoulder. Phys Ther Sport. 2019;37:120-127.

Fredberg

Bolvig

. Significance of ultrasonographically detected asymptomatic tendinosis in the patellar and Achilles tendons of elite soccer players: a longitudinal study. Am J Sports Med. 2002;30(4):488-491.

Hibberd

Myers

. Practice habits and attitudes and behaviors concerning shoulder pain in high school competitive club swimmers. Clin J Sport Med. 2013;23(6):450-455.

Hill

Collins

Posthumus

. Risk factors for shoulder pain and injury in swimmers: a critical systematic review. Phys Sportsmed. 2015;43(4):412-420.

Leong

Tsui

Ying

Leung

. Ultrasound measurements on acromio-humeral distance and supraspinatus tendon thickness: test-retest reliability and correlations with shoulder rotational strengths. J Sci Med Sport. 2012;15(4):284-291.

Malliaras

Purdam

Maffulli

Cook

. Temporal sequence of greyscale ultrasound changes and their relationship with neovascularity and pain in the patellar tendon. Br J Sports Med. 2010;44(13):944-947.

10.

McMaster

. Shoulder injuries in competitive swimmers. Clin Sports Med. 1999;18(2):349-vii.

11.

McMasters

Roberts

Stoddard

McMaster

Troup

. A survey of interfering shoulder pain in United States competitive swimmers. Am J Sports Med. 1993;21(1):67-70.

12.

Morouço

Marinho

Keskinen

Badillo

Marques

. Tethered swimming can be used to evaluate force contribution for short-distance swimming performance. J Strength Cond Res. 2014;28(11):3093-3099.

13.

Ooi

Schneider

Malliaras

, et al. Sonoelastography of the Achilles tendon: prevalence and prognostic value among asymptomatic elite Australian rules football players. Clin J Sport Med. 2016;26(4):299-306.

14.

Porter

Blanch

Walker

Shield

. The effect of previous shoulder pain on supraspinatus tendon thickness changes following swimming practice. Scand J Med Sci Sports. 2020;30(8):1442-1448.

15.

Porter

Talpey

Pascoe

Blanch

Walker

Shield

. The effect of swimming volume and intensity on changes in supraspinatus tendon thickness. Phys Ther Sport. 2021;47:173-177.

16.

Sein

Walton

Linklater

, et al. Shoulder pain in elite swimmers: primarily due to swim-volume-induced supraspinatus tendinopathy. Br J Sports Med. 2010;44(2):105-113.

17.

Walker

Gabbe

Wajswelner

Blanch

Bennell

. Shoulder pain in swimmers: a 12-month prospective cohort study of incidence and risk factors. Phys Ther Sport. 2012;13(4):243-249.

18.

Weldon

Richardson

. Upper extremity overuse injuries in swimming: a discussion of swimmer’s shoulder. Clin Sports Med. 2001;20:423-438.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.15 MB