The effect of previous shoulder pain on supraspinatus tendon thickness changes following swimming practice

Abstract

Objectives To assess if swimming practice results in changes in supraspinatus tendon thickness, acromiohumeral distance, and occupational ratio in shoulders of elite swimmers with and without a history of shoulder pain. Design Case‐Control study. Methods A convenience sample of fifty elite swimmers (14‐22 years) were recruited for this study. Groups were defined by the presence (history of pain, N = 37) or absence (pain free, N = 63) of significant interfering shoulder pain within the previous 6 months. The current study analyzed supraspinatus tendon thickness, acromiohumeral distance, and the occupational ratio, through the use of ultrasound. Measures were taken prior to swim practice; immediately after practice; and 6 hours post‐practice. Results No statistically significant difference in supraspinatus tendon thickness, acromiohumeral distance or ratio between shoulders with and without a history of pain were found at rest. Following a swimming practice, both shoulders with and without a history of pain had a significant increase in tendon thickness (0.27 & 0.17 mm; P ≤ .001 & <.001). The increase in thickness was significantly greater in the history of pain shoulders compared to pain‐free shoulders (P = .003). At 6‐hour post‐practice, the history of pain shoulders was still significantly thicker than their pre‐practice (rested) levels (P = .007). Despite changes in tendon thickness, the occupational ratio remained non‐significant between groups. Conclusion Shoulders with a history of pain show an altered response to swimming practice. The results of the current study have implications for training load and injury management. It should prompt investigation into how the tendon reacts under varying load conditions.

The effect of swimming volume and intensity on changes in supraspinatus tendon thickness

“…Further to this it has been found that STT changes following a swimming practice are significantly different in those swimmers with a history of shoulder pain 9 . While both pain free shoulders and shoulders with a history of pain increased in STT following practice, those shoulders with a history of pain showed a greater increase in STT following practice and remained thicker at six hours post practice 9 . Given that STT responds to swimming load and its capability to return to baseline may be compromised in individuals with a history of shoulder pain, it is postulated that monitoring the thickness of the tendon could be an effective tool for assessing the response of the shoulder to a given training load.…”

“…Findings have demonstrated that subjects with painful rotator cuff tendinopathy had a significantly greater increase in supraspinatus tendon thickness (STT) at one and six hours following a loading protocol (McCreesh et al, 2017). Further to this it has been found that STT changes following a swimming practice are significantly different in those swimmers with a history of shoulder pain 9 . While both pain free shoulders and shoulders with a history of pain increased in STT following practice, those shoulders with a history of pain showed a greater increase in STT following practice and remained thicker at six hours post practice 9 .…”

“…Ultrasonographic measurements of swimmers' supraspinatus tendon thicknesses (STT), in millimetres, were obtained using a Mindray DP-20 Ultrasound machine in conjunction with a 38mm 7.5MHz Mindray 75L38EB linear transducer (Mindray, Shenzhen China). All ultrasound images were obtained by a single examiner using the technique previously described 9 . The examiner had undergone advanced training in musculoskeletal ultrasound imaging and demonstrated excellent test-retest reliability measures for STT (ICC = 0.99, 95% CI = 0.98-1.00, SEM = 0.09 mm) and corresponding minimal detectable change 0.25 mm 9 .…”

“…All ultrasound images were obtained by a single examiner using the technique previously described 9 . The examiner had undergone advanced training in musculoskeletal ultrasound imaging and demonstrated excellent test-retest reliability measures for STT (ICC = 0.99, 95% CI = 0.98-1.00, SEM = 0.09 mm) and corresponding minimal detectable change 0.25 mm 9 .…”

Supraspinatus Tendon Changes and Glenohumeral Range of Motion in College Baseball Players

“…Thus, understanding possible mechanisms behind increases in SST thickness yields valuable information for managing throwing-related rotator cuff tendon injuries. SST thickness has been measured using ultrasound imaging [29,[31][32][33], which is a reliable tool to study for this purpose [34,35]. Given the various tissue mechanism of glenohumeral ROM alterations and the likelihood of throwing shoulder injuries on the SST, specific glenohumeral ROM might be associated with SST thickness measured with ultrasound.…”