Clinical and ultrasound findings of ‘swimmer’s shoulder’ and its association with training history in elite Portuguese swimmers: a cross-sectional study

ABSTRACT

Objectives

To assess the prevalence of shoulder injuries and ultrasound findings in elite Portuguese swimmers and their association with symptoms and personal or training-related factors.

Methods

This cross-sectional study was conducted at the Portuguese Open and Youth Swimming National Championships between 27 and 30th July 2022. Each athlete entered details regarding personal and training history into a questionnaire and underwent a physical and ultrasound shoulder examination.

Results

A total of 102 swimmers out of 662 Portuguese athletes were included in the study. Shoulder pain experienced during the previous season was reported by 42% of the athletes. A high prevalence of shoulder structural abnormalities was noted, specifically supraspinatus tendinosis (91%), tears (29%), and subacromial bursitis (29%). Specific training for injury prevention was associated with higher rates of infraspinatus tendinosis (p = 0.047), and supraspinatus tears were linked to greater swimming distances per week (p < 0.001) and practice (p < 0.001), more years of practice (p = 0.018), shoulder pain at the time of evaluation (p = 0.023), a higher number of missed competitions (p = 0.041), and shoulder injections (p = 0.009). Subacromial bursitis was associated with shoulder pain at the time of evaluation (p = 0.002) and during the previous season (p < 0.001), missed competitions (p < 0.001), and requirement for physical therapy (p = 0.006).

Conclusions

A high prevalence of shoulder morphological changes was found in surveyed swimmers and there were several associations with training load, regardless of individual characteristics of each athlete. It is essential to understand the true impact of current injury prevention programs and to develop effective measures to protect swimmers’ health.

KEYWORDS:

• Swimming
• rotator cuff
• shoulder injuries
• shoulder impingement syndrome
• bursitis

Acknowledgements

The authors would like to thank all swimmers and swimming teams that participated in the study and General Electric Healthcare Portugal for allowing us to use a portable ultrasound system free of charge. We would also like to thank Editage (www.editage.com) for English language editing. Finally, the authors would like to offer their sincere gratitude to the Portuguese Swimming Federation for their support and cooperation during the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Consent to participate

Participants or their legal guardians provided informed consent to participate in the study.

Consent to publish

Participants or their legal guardians provided consent to publish their data.

Data availability statement

The additional datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.