Context: Training loads, injury, and injury prevention in the Para sports population has not been well established. Objective : The purpose of this study was to survey elite-level swimming, cycling, and athletic Para sport athletes in the United States who were competing in the 2016 US Paralympic trials to better understand common injuries among athletes in each sport and to determine whether injury prevention programs were being utilized. Design: Cross-sectional, survey study. Setting: The 2016 US Paralympic trials for swimming, cycling, and athletics. Participants: Athletes who competed in swimming, cycling, and/or athletics at the 2016 US Paralympic trials (N = 144; 83 males and 61 females). Main Outcome Measures: Participants completed electronic survey using Qualtrics XM (Qualtrics, Provo, UT) with questions pertaining to average number of hours trained per week, number of cross-training hours performed each week, descriptive information regarding sport-related injuries, pain, whether athletes received treatment for injuries, and descriptive information regarding whether the athletes had participated in an injury prevention program. Results: Over 64% of respondents reported training greater than or equal to 11 hours per week, and 45% of athletes reported spending greater than or equal to 6 hours per week cross-training. Forty-two percent of athletes reported currently having pain with 34% reporting missing a competition because of injury. Only 24% of respondents reported having participated in an injury prevention program. Conclusions: Many Para sport athletes train at similar durations as able-bodied counterparts and have pain that interferes with their ability to train and compete, however, only a small percentage consistently perform injury prevention programs.
Shana E. Harrington, Sean McQueeney, and Marcus Fearing
Shana Harrington, Corinne Meisel, and Angela Tate
The prevalence of shoulder pain in the competitive swimming population has been reported to be as high as 91%. Female collegiate swimmers have a reported shoulder-injury rate 3 times greater than their male counterparts. There has been little information on how to best prevent shoulder pain in this population. The purpose of this study was to examine if differences exist in shoulder range of motion, upper-extremity strength, core endurance, and pectoralis minor length in NCAA Division I female swimmers with and without shoulder pain and disability.
NCAA Division I females (N = 37) currently swimming completed a brief survey that included the pain subscale of the Penn Shoulder Score (PSS) and the sports/performing arts module of the Disabilities of the Arm, Shoulder, and Hand (DASH) Outcome Measure. Passive range of motion for shoulder internal rotation (IR) and external rotation (ER) at 90° abduction was measured using a digital inclinometer. Strength was measured using a handheld dynamometer for scapular depression and adduction, scapular adduction, IR, and ER. Core endurance was assessed using the side-bridge and prone-bridge tests. Pectoralis minor muscle length was assessed in both a resting and a stretched position using the PALM palpation meter. All measures were taken on the dominant and nondominant arms.
Participants were classified as positive for pain and disability if the following 2 criteria were met: The DASH sports module score was >6/20 points and the PSS strenuous pain score was ≥4/10. If these criteria were not met, participants were classified as negative for pain and disability. Significant differences were found between the 2 groups on the dominant side for pectoralis muscle length at rest (P = .003) and stretch (P = .029).
The results provide preliminary evidence regarding an association between a decrease in pectoralis minor length and shoulder pain and disability in Division I female swimmers.
Angela Tate, Shana Harrington, Melissa Buness, Susan Murray, Caitlin Trout, and Corinne Meisel
Youth- through masters-level competitive swimmers incur significant shoulder pain. Risk factors associated with shoulder pain include high swimming yardage, a lack of cross-training, decreased shoulder strength and reduced core endurance, and limited posterior shoulder and pectoral length. Since training, swimming exposure, and physical-performance measures have all been associated with shoulder pain, the methods used to train swimmers may influence the development of shoulder pain, yet studies delineating training methods are lacking.
To identify in-water and dry-land practices among youth- through masters-level swimmers in the United States (US) and describe the potential effects of training practices on swimmers’ shoulders.
A Web-based survey was developed to identify common training practices in 5 areas: quantification of swimming and dry-land training and in-water techniques such as kicking drills, upper-body stretching, shoulder and core strengthening, and cross-training.
156 swim-team coaches or captains of youth, high school, and college swim teams and 196 masters swimmers participated (N = 352). There was geographic representation from across the US.
Responses indicated diverse training practices. However, most respondents used kicking drills, which may provoke shoulder pain due to prolonged poor positioning. High yardage swum by high school and college teams increases their risk of shoulder tendinopathy. Stretching and strengthening exercises and dosages commonly used were inconsistent with current research recommendations and lacked specificity in terms of addressing typical mobility restrictions and muscle weaknesses described in the swimming literature. Core strengthening and cross-training are frequently performed.
Several areas of in-water and dry-land practice were identified that may put swimmers’ shoulders at risk for injury. Further research regarding the safety and efficacy of training programs is recommended to determine optimal methods of injury prevention and performance enhancement.