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Freestyle stroke cycle pull-through and recovery of the right arm during a single stroke. (Used with permission from Colwin CM. Breakthrough Swimming. Champaign, IL: Human Kinetics; 2002:50-70.)
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Competitive swimming has become an increasingly popular sport in the United States. In 2007, more than 250 000 competitive swimmers were registered with USA Swimming, the national governing body. The average competitive swimmer swims approximately 60 000 to 80 000 m per week. With a typical count of 8 to 10 strokes per 25-m lap, each shoulder perfo...
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Citations
... In animal models, the pattern of muscle contraction elicited during swimming could explain the differences found between femur and tibia cortical geometry. In humans, freestyle kicking during swimming primarily recruits the hip flexors and extensors, since knee flexion and extension generates a less propulsive force [99,100]. Gluteus maximus, biceps femoris and rectus femoris, which all have insertions at the femur, are more intensely recruited than gastrocnemius and tibialis anterior during the swimming kick [101]. ...
Background
The effect of swimming on bone health remains unclear, namely due to discrepant findings between studies in humans and animal models.
Objective
The aim of this systematic review and meta-analysis is to identify the available evidence on the effects of swimming on bone mass, geometry and microarchitecture at the lumbar spine, femur and tibia in both humans and rodent animal models.
Methods
The study followed PRISMA guidelines and was registered at PROSPERO (CRD4202236347 and CRD42022363714 for human and animal studies). Two different systematic literature searches were conducted in PubMed, Scopus and Web of Science, retrieving 36 and 16 reports for humans and animal models, respectively.
Results
In humans, areal bone mineral density (aBMD) was similar between swimmers and non-athletic controls at the lumbar spine, hip and femoral neck. Swimmers' tibia diaphysis showed a higher cross-sectional area but lower cortical thickness. Inconsistent findings at the femoral neck cortical thickness were found. Due to the small number of studies, trabecular microarchitecture in human swimmers was not assessed. In rodent models, aBMD was found to be lower at the tibia, but similar at the femur. Inconsistent findings in femur diaphysis cross-sectional area were observed. No differences in femur and tibia trabecular microarchitecture were found.
Conclusion
Swimming seems to affect bone health differently according to anatomical region. Studies in both humans and rodent models suggest that tibia cortical bone is negatively affected by swimming. There was no evidence of a negative effect of swimming on other bone regions, both in humans and animal models.
... The power generated by the shoulder during swimming can be seen by swimmers having the largest IRD shoulder strength of the sports disciplines studied. This large shoulder strength could have issues if not balanced by the TRS, as a lower contribution of trunk stabilizing muscles during swimming can lead to shoulder pain and injury (Heinlein and Cosgarea, 2010;Matsuura et al., 2022). Coaches can optimise performance of their swimmers and reduce injury risk by analysing the shoulder-trunk relationships. ...
Introduction: Trunk and shoulder strength are consistently shown to be involved in performance limitations, as well as contributing to stability, power output, and reducing the risk of injury. Although their biomechanical interaction is a critical aspect for athletes, there is limited research on the relationship between trunk and shoulder strength in sports where upper body mechanics are critical for optimal performance.
Purpose: This study examined the differences and relationships between trunk rotational strength and shoulder rotational strength among athletes participating in mixed martial arts (MMA), tennis, swimming, and baseball.
Methods: Maximal voluntary contraction tests were performed to evaluate strength of 39 professional adult male athletes from disciplines of MMA (n = 6), tennis (n = 11), swimming (n = 11) and baseball (n = 11). Peak force data were used in sports comparison and relationship analysis between trunk and shoulder rotation strength parameters.
Results: The findings revealed a complex and significant relationship between trunk and shoulder strength, with unique patterns for each athletic discipline. Tennis players exhibited a strong correlation between trunk bilateral differences and internal shoulder rotation, while other disciplines demonstrated a more balanced use of trunk asymmetry. Swimmers displayed the best interactions between trunk and shoulder overall, emphasizing the aquatic environment’s biomechanical demands. In MMA, the strongest correlation was between shoulder internal and external rotation with the trunk, mainly due to the number of defensive movements in addition to offensive ones. Baseball pitchers showed a significant correlation between internal/external shoulder rotation strength ratio and trunk asymmetry.
Conclusion: While no differences in peak force variables were found, unique relationships between trunk and shoulder rotational performance were discovered. The results suggest a long-term sport-specific adaptation of the trunk-shoulder interaction in sports that require upper limb power movements. It seems, that the relationship between the various parameters of trunk and shoulder was influenced by the movement stereotype of each sport. Therefore, recognition of sport-specific interactions is critical to the development of effective training programs that enhance performance and potentially reduce injury risk in different sports. Researchers and practitioners should focus on longitudinally monitoring fluctuations in TRS and SRS relationships throughout each sport season and examining potential associations with injury incidence.
... This association may be explained by the muscles involved in the lat pull-down and freestyle stroke. It is worth noting that for both able-bodied and Paralympic athletes, this on-land exercise (i.e., lat pull-down) involves the activation of the latissimus dorsi muscle, which is an important muscle in swimming related to swimming propulsion and upper body strength during the freestyle stroke [42,43]. ...
... By examining multiple regression analysis in the bench press, it has been shown that mean swimming velocity can be predicted by the normF@Pmax and V@Pmax (42.3% and 65.8%, respectively). Notably, this exercise is important to optimize pectoral major shoulder and triceps muscle strength, which has an influence on the early and late pull phase in freestyle technique [43]. ...
This study aimed to identify the relationship between dryland tests and swimming performance in elite Paralympic swimmers. Fifteen competitive swimmers (age: 27.4 ± 5.4 years, height: 1.70 ± 6.8 m, body mass: 67.9 ± 9.2 kg; 9 males, 6 females) performed a lat pull-down and a bench press incremental load test to determine maximum power (Pmax), the strength corresponding to maximum power (F@Pmax), and the barbell velocity corresponding to maximum power (V@Pmax) from the force–velocity and power–velocity profiles. These outcomes were also normalized by the athlete’s body mass. Swimming performance was carried out from the best result in a 100 m freestyle race registered during an international competition. Lat pull-down F@Pmax was significantly associated with 100 m freestyle chronometric time (ρ = −0.56, p < 0.05), and lat pull-down V@Pmax presented a relationship with mean swimming velocity (ρ = 0.71, p < 0.01). Similarly, bench press F@Pmax and the normalized F@Pmax were significantly related to the mean swimming velocity (ρ = −0.51, ρ = −0.62, p < 0.05). Stepwise multiple regression showed that lat pull-down V@Pmax, bench press normF@Pmax, and V@Pmax accounted for 40.6%, 42.3%, and 65.8% (p < 0.05) of the mean swimming velocity variance. These preliminary results highlighted that simple dryland tests, although with a moderate relationship, are significantly associated with 100 m freestyle swimming performance in elite Paralympic swimmers.
... Functional Training in Swimmer's Shoulder: 7 The dynamic stabilizers of the shoulder complex must activate consistently and in unison for best athletic performance. Strengthening exercises should replicate the functional requirements associated with sport-specific skills. ...
Background: The purpose of this study was to investigate the effectiveness of 6-week Serratus Anterior trainingVersus Subscapularis training in improving the performance in a Swimmer’s Shoulder.Purpose: To compare the effect of Serratus Anterior strength training versus Subscapularis strength training onshoulder pain in terms of performance in Swimmer’s.Materials and Methods: Subjects were randomly assigned into two groups i.e. Group A and B. The subjects wereassessed using an assessment form, UQYBT, DASH score, and 50 meters (m) freestyle sprint for disability andevaluate performance before the commencement of treatment and also reassessed after 6 weeks of treatment.The sample of 40 subjects has been randomized into either Group A (Serratus Training) or Group B (SubscapulisTraining) in a 1:1 ratio.Results: The study results suggest that Group B has an effect on performance improvement in Swimmers withshoulder pain after a 6-week intervention. The mean 50m sprint scores in Group A before treatment is 29.9960 andit is decreased to 29.0425.Conclusion: Hence, this study concludes that the mean difference of Group B is slightly more effective than GroupA in terms of performance in swimmers’ shoulders in all standard measures.
... week [6]. It is proposed that numerous shoulder movement repetitions can contribute to joint inflammation and pain [7]. ...
Biomechanics and training load monitoring are important for performance evaluation and injury prevention in elite swimming. Monitoring of performance and swim stroke parameters is possible with inertial measurement units (IMU) but has not been validated in para-swimmers. The purpose of this study was to validate a single IMU-based system to accurately estimate pool-swam lap time, stroke count (SC), stroke duration, instantaneous stroke rate (ISR), and distance per stroke (DPS). Eight Paralympic athletes completed 4 × 50 m swims with an IMU worn on the sacrum. Strokes cycles were identified using a zero-crossing algorithm on the medio-lateral (freestyle and backstroke) or forward-backward (butterfly and breaststroke) instantaneous velocity data. Video-derived metrics were estimated using Dartfish and Kinovea. Agreement analyses, including Bland–Altman and Intraclass Correlation Coefficient (ICC), were performed on all outcome variables. SC Bland–Altman bias was 0.13 strokes, and ICC was 0.97. ISR Bland–Altman biases were within 1.5 strokes/min, and ICCs ranged from 0.26 to 0.96. DPS Bland–Altman biases were within 0.20 m, and ICCs ranged from 0.39 to 0.93. A single-IMU system can provide highly valid performance and swim stroke monitoring data for elite para-swimmers for the majority of strokes, with the exception of backstroke. Future work should improve bilateral stroke detection algorithms in this population.
... 2 In competitive swimming, the strong propulsive force generated by the upper limbs account for 80%-90% of the swim velocity and the shoulder moves into internal rotation, extension, and adduction at the glenohumeral joint during the pull-through phase. 3 Thus, the eccentric shoulder external rotation has been characterized as counteracting the propulsive internal rotation, thereby providing dynamic stabilization of the glenohumeral joint. 4 In addition, electromyographic findings in competitive swimmers without shoulder pain supported this argument. ...
... There are several published papers on shoulder pain in the swimmer [12,19,[24][25][26][27][28][29][30][31][32][33][34][35][36]. To our knowledge, a few studies exist on Masters swimmers [21,32,[37][38][39]. ...
... Several studies have shown how different groups of muscles are enrolled in the various phases of the movement [12,14,19,31,34,43,46] and how muscle fatigue can promote shoulder pain [34,42,[47][48][49][50]. ...
... Furthermore, there is a large body of work in the literature that has investigated the influence of the strength of individual muscle groups on performance and on the risk of injuries [12,14,19,31,34,43,46]. This means that, for a complete examination of the swimmer, the muscle evaluation cannot be ignored. ...
Background: Swimming and, specifically, front crawl, can be included among the “overhead” sports. Overhead sports are a risk factor for some problems of the musculoskeletal system, especially the shoulder. The aim of this study was to assess the incidence of shoulder and neck pain in a Masters Swimming Team and its correlation with the crawl stroke. Methods: This is an observational study through video-analysis of the stroke and a questionnaire. The participants selected for the present study were 61 athletes of a Masters team, whose prevailing training stroke was the front crawl. Their stroke was analyzed during training using a go-pro camera mounted on a sliding trolley on a track, evaluating their technical defects with their trainer. A questionnaire about frequency of shoulder and neck pain during the last five years was administered to all the participants at the study. Results: From the questionnaire, 45 and 55 out of 61 athletes had suffered from shoulder pain and cervical pain, respectively. Both types of pain were correlated with the weekly swimming volume. The swimmers with hyperflexion of the wrist and prolonged internal rotation in the pulling phase had shoulder problems. Those who suffered from current shoulder pain reduced the underwater time. The four swimmers with an excessive body roll during breathing and those who kept their heads extended, reported cervical pain. Conclusions: Shoulder and neck pain could be prevented with the correction of specific technical errors in crawl stroke.
... The literature has shown that an incorrect stroke, with errors in one or the other phase of the movement, can cause shoulder symptoms [14,15]. To our knowledge, only a few articles are published that relate swimming to neck pain [16][17][18][19]. ...
... There are several published papers on shoulder pain in the swimmer [12][13][14][15]20,22,[25][26][27][28][29][30][31][32][33][34][35][36]. To our knowledge, a few studies exist on Masters swimmers [17,32,[37][38][39]. ...
... Several studies have shown how different groups of muscles are enrolled in the various phases of the movement [12,14,15,31,34,43,46] and how muscle fatigue can promote shoulder pain [34,42,[47][48][49][50]. ...
Background: Swimming and, specifically, front crawl, can be included among the "overhead" sports. Overhead sports are a risk factor for some problems of the musculoskeletal system, especially the shoulder. The aim of the study was assessing the incidence of shoulder and neck pain in a Masters Swimming Team and its correlation with the crawl stroke. Methods: It is an observational study through video-analysis of the stroke and a questionnaire. The participants are 61 athletes of a Master team, whose prevailing training stroke was the front crawl were selected for the present study. Their stroke was analyzed during training by a go-pro camera mounted on a sliding trolley on a track, evaluating with their trainer their technical defects. A questionnaire about frequency of shoulder and neck pain during the last five years was administered to all the participants at the study. Results: From the questionnaire, 45 and 55 out of 61 athletes had suffered from shoulder pain and cervical pain, respectively. Both types of pain were correlated with the weekly swimming volume. The swimmers with hyperflexion of the wrist and prolonged internal rotation in the pulling phase had shoulder problems. Those who suffered from current shoulder pain reduced the underwater time. The four swimmers with an excessive body roll during breathing and those who kept their heads extended, reported cervical pain. Conclusions: Shoulder and neck pain could be prevented with the correction of specific technical errors in crawl stroke.
... Swimming is a unique sport that combines endurance, strength, and physical control in an environment in which the use of body weight is drastically reduced [1]. Participation in competitive swimming is constantly increasing in terms of the number of swimmers [2]. Competitive-level swimmers may have five to seven training sessions per week and often double sessions in a day [3]. ...
... This is also shown by 52% of high-level athletes reporting pain in the shoulder girdle, while the percentage of painful cases in athletes of a lower competitive level is estimated to be around 27%. This marked difference may be attributed to both an increased number of training hours and the long-term involvement in the sport that distinguishes high-level swimmers [2]. The incidence rates of so-called "swimmers' shoulder" show that it can affect 91% of competitive swimmers [1]. ...
... Prior to the questionnaire procedure, a member of the research group recorded the demographic and training characteristics of each participant (first and last name, sex, weight, height, age, predominant arm, training frequency/week in water, training frequency/week on land, training hours/session in water, training hours/session out of the water, main event and personal records). The questionnaire used was the Shoulder Pain and Disability Index (SPADI) [2], validated for Greek data, referring to the previous occurrence of shoulder pain. The athletes individually answered the questions of the questionnaire, which were divided into two categories, one indicative of pain (five questions with answers from 0 (no pain) to 10 (worst pain imaginable)), and the other indicative of functional disability (eight questions with answers from 0 (no difficulty) to 10 (so difficult to require help)). ...
Shoulder pain is a common syndrome in swimming and affects a large number of competitive swimmers. The purpose of the study was to investigate the relationship between pain in the shoulder girdle and the endurance of the trunk muscles in young swimmers. A total of 24 boys and 22 girls, aged 13 to 18 years, participated in the study. The measurements included the completion of a questionnaire (Shoulder Pain and Disability Index, SPADI) and a field test (McGill’s Torso Muscular Endurance Test). The total SPADI score correlated weakly and negatively with the endurance time of back muscles in both sexes (r2 = 0.10, p = 0.035), and moderately and negatively in girls (r2 = 0.23, p = 0.023). A weak negative correlation was found between the disability index and the back muscles’ endurance time in both sexes (r2 = 0.15, p = 0.007), which was moderate in girls only (r2 = 0.25, p = 0.019). The disability index displayed moderate negative correlations with the right oblique’s (r2 = 0.18, p = 0.049) and left oblique’s endurance time (r2 = 0.23, p = 0.024) in girls. Weight, body mass index, the total out-of-water training time per week and age significantly affected the endurance times of the trunk muscles in boys and girls (p < 0.05). In conclusion, strengthening the dorsal and the oblique muscles could reduce shoulder pain and disability in young swimmers and especially girls.
... Swimmers' shoulder complex is largely responsible for propulsive power in the four competitive swimming techniques, with shoulder extension crucial during most propulsive phases (Heinlein & Cosgarea, 2010;Wanivenhaus et al., 2012). Lower limb strength and power are largely associated with both start and turn swimming skills (West et al., 2011;Keiner et al., 2021), as well as with overall performance, contributing decisively to sprint event success (Keiner et al., 2021). ...
Swimming performance is likely influenced by strength, but differences between butterfly, backstroke, breaststroke and front crawl, as well as between novice and expert swimmers, are unclear. We have examined the associations between sprint performances, upper and lower limb strength, and anthropometric characteristics in 14 (six males and eight females) non-elite and 16 (nine males and seven females) elite-level swimmers. After an anthropometric characterisation, participants performed four 25 m maximal swims (one per technique) with 10 min intervals, right and left shoulder flexion/extension isokinetic testing at 90 and 300º/s angular velocities and three countermovement jumps. Pearson correlation analysis showed that sprint times were moderate-largely negatively correlated with upper and lower limb strength and power (r ± 95%CI = 0.39 ± 0.26-0.77 ± 0.13, p < 0.05). Elite swimmers higher strength levels were associated with longer stroke length in butterfly and front crawl, and with higher stroke rate in backstroke and breaststroke (r ± 95%CI = 0.37 ± 0.32-0.68 ± 0.21; p < 0.05). Butterfly, backstroke and front crawl sprint times were moderate-largely negatively related with arm span (r ± 95%CI = 0.37 ± 0.26, 0.39 ± 0.25 and 0.69 ± 0.17, p < 0.05). The predictive model indicated that higher dry-land strength values distinguished elite from non-elite swimmers (r2 = 0.67-0.81; p < 0.001). This association was not observed per performance level and per sex, confirming that sprint swimming performance levels can be differentiated by dry-land strength testing.
