[The high level swimmer articular shoulder complex].
OBJECTIVE
To analyze the shoulder joint complex in high level swimmers. We formulated the assumption that high level swimming weakens this complex, resulting in laxity of the anterior-inferior capsuloligamentous structures with atraumatic anterior instability, impingement with rotator cuff tendonitis and muscle imbalance of the rotator cuff muscles.


METHODS
Two 20-subject groups took part in this study (a group of high level swimmers and a group of sedentary people). The swimmers were all national-level front crawl specialists. The evaluations included clinical examination and isokinetic testing of the shoulder.


RESULTS
Isokinetic testing (at 60 degrees /s) revealed that the swimmers have an external rotation/internal rotation ratio that is unbalanced (right shoulder: 0.52) and significantly lower than that seen in sedentary subjects (right shoulder: 0.75). Even though swimming is a symmetrical sport, our data confirm that intensive front crawl swimming involves asymmetry, with a stronger shoulder (right shoulder: 61.2+/-10.2 Nm; left shoulder: 52.8+/-9.8 Nm). The results of the clinical examination showed that 55% of the swimmers presented scapular protraction and that 35% were positive for mechanical impingement. These clinical elements were not observed in the control group. Laxity of the anterior-inferior capsuloligamentous structures was also noted in 67% of the swimmers.


CONCLUSIONS
high level swimming ineluctably weakens the shoulder joint complex.
Olivier
N
N
Centre de rééducation Les Hautois, place de la IV-République, 62590 Oignies, France. oliviern@neuf.fr
Quintin
G
G
Rogez
J
J
D003627:Data Interpretation, Statistical; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D017006:Rotator Cuff; D019534:Shoulder Impingement Syndrome / Q000209:etiology; D012785:Shoulder Joint / Q000502:physiology / Q000503:physiopathology; D013550:Swimming / Q000502:physiology; D052256:Tendinopathy / Q000209:etiology; D013997:Time Factors