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Supraspinatus tendinosis seen in 67% of elite swimmers

Authors: Matt Hasson

References: Orthopaedics Today, 2005

Abstract
A study of 52 elite swimmers suggested there is a strong relationship between swimming time and distance and the incidence of supraspinatus tendinosis, a frequent cause of shoulder pain in swimmers.

The swimmers (28 male and 24 female) ranged in age from 13 to 25 years. More than half of the athletes had supraspinatus tendinosis, according to the test results.

The study was observational only and did not involve treatment for tendinosis. It comprised clinical examinations, MRIs and a questionnaire, and focused mostly on aquatic training. It did not include swimmers with previous shoulder surgeries, fractures or dislocations, said Mya Lay Sein, MBBS, MSpMed, of Sydney.

She discussed the study at the American Orthopaedic Society for Sports Medicine 2005 Annual Meeting. She and her co-authors sought a correlation between training routines and supraspinatus tendinopathy in competitive swimmers.

The MRIs used oblique coronal proton density (PD) and fat-suppressed T2, sagittal T2 axial PD and fat-suppressed PD sequencing. The MRI showed that 35 swimmers (67%) had supraspinatus tendinosis. Sein and her associates saw a strong connection between a positive impingement sign and MRI-determined supraspinatus tendinosis (P<.001, Fisher exact test, 100% sensitivity and 65% specificity).

Time, distance affect tendinosis
The authors found that the amount of time and distance the athletes swam weekly influenced the development of supraspinatus tendinosis. Swimmers who trained more than 15 hours weekly were twice more likely to have tendinopathy than those who trained less.

Those who swam more than 35 km weekly were four times more likely to have the condition, Sein said.

“I hope these results will help [others] understand shoulder problems in swimmers,” said Sein, an avid athlete and sports medicine specialist at the Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales in Sydney.

“I would like to suggest to parents and coaches, please be aware of the effect of training volume on shoulder tendinopathy. Our results suggest that, if possible, you should keep the volume of training to less than 15 hours and less than 35 km per week,” she said.

The study also revealed no relationship between specific swimming strokes used and the incidence of tendinopathy, Sein added.

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