Shoulder Pain in Elite Swimmers: Primarily Due to Swim-volume-

Background/Hypothesis: Shoulder pain in elite swimmers is common and its pathogenesis is uncertain. Hypothesis/Study Design: We used a cross-sectional study design to test Jobe’s hypothesis that repetitive forceful swimming leads to shoulder laxity which in turn leads to impingement pain. Methods: Eighty young elite swimmers (13-25 years of age) completed questionnaires on their swimming training, pain, and shoulder function. They were given a standardized clinical shoulder examination, and tested for glenohumeral joint laxity using a non-invasive electronic laxometer. 52/80 swimmers also attended for shoulder magnetic resonance imaging (MRI). Results: 73/80 (91%) swimmers reported shoulder pain. Most (84%) had a positive impingement sign and 69 % of those examined with MRI had supraspinatus tendinopathy. The impingement sign and MRI-determined supraspinatus tendinopathy correlated strongly (rs=0.49, p<0.00001). Increased tendon thickness correlated with supraspinatu