Clinical Findings in Competitive Swimmers with Shoulder Pain

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Abstract
We clinically evaluated 36 competitive swimmers who had shoulder pain; the majority were women. Twenty- three swimmers had unilateral shoulder pain and 13 had bilateral pain, making a total of 49 painful shoul ders. Shoulder pain had been present significantly longer in swimmers with bilateral shoulder pain (mean, 104 weeks) than in swimmers with unilateral pain (mean, 33 weeks). Twelve shoulders exhibited signs of impingement without excessive humeral head transla tion. In 25 shoulders, concomitant signs of impinge ment and increased glenohumeral translation, together with a positive apprehension sign, were found. Four swimmers, who were generally joint hypermobile, ex hibited bilateral impingement signs and excessive hu meral head translation, most commonly in the antero inferior direction. Four shoulders had excessive humeral head translation and apprehension without impingement. Lack of coordination in the scapulo humeral joint was seen significantly more often in symptomatic than in asymptomatic shoulders. Hawkins' test for impingement was more sensitive than Neer's test. Swimmers with shoulder pain have vari able clinical findings. The majority demonstrate signs of impingement and increased humeral head transla tion in the anteroinferior direction together with a pos itive apprehension sign. This nontraumatic instability might result from wearing of the anteroinferior capsu loligamentous complex. The different clinical findings might represent different stages of the same condition.

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