﻿{"id":227663,"date":"2016-11-02T10:00:13","date_gmt":"2016-11-02T17:00:13","guid":{"rendered":"https:\/\/www.swimmingworldmagazine.com\/news\/?p=227663"},"modified":"2016-11-02T09:24:32","modified_gmt":"2016-11-02T16:24:32","slug":"2-missing-parts-of-your-swimmers-shoulder-injury-prevention-program","status":"publish","type":"post","link":"https:\/\/www.swimmingworldmagazine.com\/news\/2-missing-parts-of-your-swimmers-shoulder-injury-prevention-program\/","title":{"rendered":"2 Missing Parts of Your Swimmers&#8217; Shoulder Injury Prevention Program"},"content":{"rendered":"<p><em>By Dr. G. John Mullen, Swimming World Contributor<br \/>\n<\/em><br \/>\nI often discuss shoulder health, in fact many of you are probably sick of me laboring about shoulder injuries and injury prevention. Unfortunately, I feel like I&#8217;m not getting my point across, as thousands of <a href=\"http:\/\/www.trainingcor.com\" target=\"_blank\">swimmers enter our clinic each year<\/a> with shoulder pain and injury (remember <a href=\"https:\/\/www.swimmingworldmagazine.com\/news\/why-you-shouldnt-shrug-off-swimmers-shoulder\/\" target=\"_blank\">why you shouldn&#8217;t shrug off swimmer&#8217;s shoulder<\/a>). This is because teams still aren&#8217;t implementing the mandatory components of a swimmers shoulder prevention program!<\/p>\n<p>Recently, a great research study by\u00a0Matthews (2016) looked at the effects of 8\u00a0\u00d7\u00a0100\u00a0m training swims off a 2:00 interval. Target times were prescribed for each swimmer based on 85 percent of their best 100-meter times. This study suggested one set of 8 x 100 m caused the following:<\/p>\n<ul>\n<li>Impaired shoulder proprioception (joint sense of position)<\/li>\n<li>Reduced shoulder external rotation range of motion<\/li>\n<\/ul>\n<h3>Simply performing one 16-minute set greatly altered shoulder characteristics!<\/h3>\n<p>Imagine what happens to the shoulder after a whole practice, a week of winter training, or even a swimming season!<\/p>\n<p>These reasons make systematic strength training and injury prevention programs key for long-term health of the shoulder. Matthews (2016) provided excellent recommendations at the end of their article:<\/p>\n<blockquote><p>&#8220;These results, along with the clear link between training volume and impingement injuries (<a id=\"bbib8\" class=\"intra_ref\" href=\"http:\/\/www.sciencedirect.com.libproxy1.usc.edu\/science\/article\/pii\/S1466853X16300906#bib8\">Beach et\u00a0al., 1992<\/a>, <a id=\"bbib28\" class=\"intra_ref\" href=\"http:\/\/www.sciencedirect.com.libproxy1.usc.edu\/science\/article\/pii\/S1466853X16300906#bib28\">Lynch et\u00a0al., 2010<\/a>\u00a0and\u00a0<a id=\"bbib41\" class=\"intra_ref\" href=\"http:\/\/www.sciencedirect.com.libproxy1.usc.edu\/science\/article\/pii\/S1466853X16300906#bib41\">Walker et\u00a0al., 2012<\/a>), leads us to question the wisdom of adolescents swimming the high volumes reported (<a id=\"bbib1\" class=\"intra_ref\" href=\"http:\/\/www.sciencedirect.com.libproxy1.usc.edu\/science\/article\/pii\/S1466853X16300906#bib1\">Allegrucci et\u00a0al., 1995<\/a>, <a id=\"bbib28\" class=\"intra_ref\" href=\"http:\/\/www.sciencedirect.com.libproxy1.usc.edu\/science\/article\/pii\/S1466853X16300906#bib28\">Lynch et\u00a0al., 2010<\/a>\u00a0and\u00a0<a id=\"bbib36\" class=\"intra_ref\" href=\"http:\/\/www.sciencedirect.com.libproxy1.usc.edu\/science\/article\/pii\/S1466853X16300906#bib36\">Sein et\u00a0al., 2010<\/a>), without first having an injury prevention and strengthening programme focused on the functional eccentric strength of the external stabilising muscles of the shoulder. In each concentric \u2018power stroke\u2019 the small stabilising muscles must work synergistically to prevent the anterior translation of the humeral head. Continued fatigue and poor joint position sense could result in anterior humeral head translation due to the dominance of overactive pectoral minor and latisimus dorsi muscles leading to laxity of the weaker posterior muscles (<span id=\"bbib38\"><a id=\"ancbbib38\" class=\"intra_ref\" href=\"http:\/\/www.sciencedirect.com.libproxy1.usc.edu\/science\/article\/pii\/S1466853X16300906#bib38\">Tate et\u00a0al., 2012<\/a><\/span>). Anterior translation places the shoulder in a position whereby the subacromial space is compressed, potentially aggravating tissues such as the subacromial bursa and supraspinatus, leading to the impingement syndrome known as \u2018<a href=\"http:\/\/www.corswimmershoulder.com\/collections\/frontpage\/products\/cor-swimmers-shoulder-system\" target=\"_blank\">swimmers shoulder<\/a>\u2019. Anterior translation will also cause an internal rotation of the humerus putting additional strain on the long head of biceps tendon.<\/p>\n<p id=\"p0185\" class=\"svArticle section clear\">Given the significant reduction in external rotation range and increased proprioceptive variance as a result of fatigue, along with the significant correlation observed between stroke length and strength, it is possible that competitive swimmers may benefit from a shoulder external rotation strengthening programme that includes inner range external rotation activities, mobility training aimed at restoring external rotation range of motion, and proprioception training. It is possible that such a programme could help swimmers maintain stroke length and external rotation range after fatiguing swimming. This may be relevant to injury prevention because it may help swimmers offset the pull from the dominant internal rotators and reduce potential for impingement of supraspinatus tendon (<span id=\"bbib25\"><a id=\"ancbbib25\" class=\"intra_ref\" href=\"http:\/\/www.sciencedirect.com.libproxy1.usc.edu\/science\/article\/pii\/S1466853X16300906#bib25\">Kluemper et\u00a0al., 2006<\/a><\/span>).&#8221;<\/p>\n<\/blockquote>\n<p class=\"svArticle section clear\"><strong>Michael Vaandering<\/strong>, strength coach at COR, wrote a great piece differentiating the different types of impingement of the shoulder [<span class=\"title\"><a href=\"https:\/\/www.trainingcor.com\/2016\/10\/what-you-need-to-know-about-your-shoulder-impingements.html\" target=\"_blank\">Internal and External Shoulder Impingements: What You Need To Know<\/a>].\u00a0<\/span><\/p>\n<p class=\"svArticle section clear\">I&#8217;ve discussed numerous methods to restore mobility and have broken it down in great detail in\u00a0<a href=\"http:\/\/www.swimmingscience.net\/mobilityforswimmers\/\" target=\"_blank\"><em>Mobility for Swimmers<\/em><\/a>. However, eccentric posterior rotator cuff training and proprioception training I haven&#8217;t discussed as much [well, I did write this article a few years back\u00a0<span class=\"title\"><a href=\"http:\/\/www.swimmingscience.net\/shoulder-motor-control-swimmers\/\" target=\"_blank\">Forgotten Aspect of Swimmers Shoulder Prevention\/Rehabilitation: Motor Control Training!<\/a>]<\/span>.<\/p>\n<h2 class=\"svArticle section clear\">Two Missing Parts of Your Swimmers&#8217; Shoulder Prevention Program<\/h2>\n<h3 class=\"svArticle section clear\">1. Eccentric Shoulder Strengthening<\/h3>\n<div class=\"oembed-wrap\"><iframe loading=\"lazy\" title=\"Eccentric Posterior Rotator Cuff\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/AZlFNe3Huzw?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\n<h3 class=\"svArticle section clear\">2. Shoulder Proprioception Training<\/h3>\n<div class=\"oembed-wrap\"><iframe loading=\"lazy\" title=\"Shoulder Proprioception Rehabilitation\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/nmjicvL0A-8?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\n<p class=\"svArticle section clear\">For more information, checkout the Advanced Swimming Podcast, &#8220;Shoulder Pain: Strengthening, Flexibility, or Something Else?&#8221;<\/p>\n<div class=\"oembed-wrap\"><iframe loading=\"lazy\" title=\"ASP 006: Shoulder Pain: Strengthening, Flexibility, or Something Else?\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/caRuhH8JYOg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\n<p class=\"svArticle section clear\"><strong>Reference:<\/strong><\/p>\n<ol>\n<li class=\"desc\">Matthews MJ, Green D, Matthews H, Swanwick E.\u00a0<a href=\"https:\/\/www-ncbi-nlm-nih-gov.libproxy1.usc.edu\/pubmed\/27769804\">The effects of swimming fatigue on shoulder strength, range of motion, joint control, and\u00a0performance in swimmers.<\/a><span class=\"jrnl\" title=\"Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine\">Phys Ther Sport<\/span>. 2016 Aug 30. pii: S1466-853X(16)30090-6. doi: 10.1016\/j.ptsp.2016.08.011. [Epub ahead of print]<\/li>\n<\/ol>\n<div><b>*<\/b><i>All commentaries are the opinion of the author and do not necessarily reflect the views\u00a0of Swimming World Magazine nor its staff.<\/i><\/div>\n<div><span style=\"color: #53565a; font-family: calibri, sans-serif;\"><i>\u00a0<\/i><\/span><\/div>\n<div><i>*All swimming and dryland training and instruction should be performed under the supervision of a qualified coach or instructor, and in circumstances that ensure the safety of participants.<\/i><\/div>\n","protected":false},"excerpt":{"rendered":"<p>By Dr. G. John Mullen, Swimming World Contributor I often discuss shoulder health, in fact many of you are probably sick of me laboring about shoulder injuries and injury prevention.<\/p>\n","protected":false},"author":13,"featured_media":227771,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"dois","enabled":false},"version":2}},"categories":[18,17],"tags":[],"class_list":["post-227663","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-coaches-education","category-commentary"],"jetpack_publicize_connections":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.3 (Yoast SEO v24.3) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\r\n<title>2 Missing Parts of Your Swimmers&#039; Shoulder Injury Prevention Program<\/title>\r\n<meta name=\"description\" content=\"Make sure you don&#039;t miss out on these two major parts of your swimmers&#039; shoulder injury prevention program!\u00a0\" \/>\r\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\r\n<link rel=\"canonical\" href=\"https:\/\/www.swimmingworldmagazine.com\/news\/2-missing-parts-of-your-swimmers-shoulder-injury-prevention-program\/\" \/>\r\n<meta property=\"og:locale\" content=\"en_US\" \/>\r\n<meta property=\"og:type\" content=\"article\" \/>\r\n<meta property=\"og:title\" content=\"2 Missing Parts of Your Swimmers&#039; Shoulder Injury Prevention Program\" \/>\r\n<meta property=\"og:description\" content=\"Make sure you don&#039;t miss out on these two major parts of your swimmers&#039; shoulder injury prevention program!\u00a0\" \/>\r\n<meta property=\"og:url\" content=\"https:\/\/www.swimmingworldmagazine.com\/news\/2-missing-parts-of-your-swimmers-shoulder-injury-prevention-program\/\" \/>\r\n<meta property=\"og:site_name\" content=\"Swimming World\" \/>\r\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/SwimmingWorld\" \/>\r\n<meta property=\"article:published_time\" content=\"2016-11-02T17:00:13+00:00\" \/>\r\n<meta property=\"article:modified_time\" content=\"2016-11-02T16:24:32+00:00\" \/>\r\n<meta property=\"og:image\" content=\"https:\/\/vmrw8k5h.tinifycdn.com\/news\/wp-content\/uploads\/2016\/11\/shoulder-injury-prevention.png\" \/>\r\n\t<meta property=\"og:image:width\" content=\"999\" \/>\r\n\t<meta property=\"og:image:height\" content=\"768\" \/>\r\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\r\n<meta name=\"author\" content=\"G. 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