Le complexe articulaire de l’épaule du nageur de haut niveau

Abstract

Objective To analyze the shoulder joint complex in high level swimmers. We formulated the assumption that high level swimming weakens this complex, resulting in laxity of the anterior–inferior capsuloligamentous structures with atraumatic anterior instability, impingement with rotator cuff tendonitis and muscle imbalance of the rotator cuff muscles. Method Two 20-subject groups took part in this study (a group of high level swimmers and a group of sedentary people). The swimmers were all national-level front crawl specialists. The evaluations included clinical examination and isokinetic testing of the shoulder. Results Isokinetic testing (at 60 °/s) revealed that the swimmers have an external rotation/internal rotation ratio that is unbalanced (right shoulder: 0.52) and significantly lower than that seen in sedentary subjects (right shoulder: 0.75). Even though swimming is a symmetrical sport, our data confirm that intensive front crawl swimming involves asymmetry, with a stronger shoulder (right shoulder: 61.2 ± 10.2 N m; left shoulder: 52.8 ± 9.8 N m). The results of the clinical examination showed that 55% of the swimmers presented scapular protraction and that 35% were positive for mechanical impingement. These clinical elements were not observed in the control group. Laxity of the anterior–inferior capsuloligamentous structures was also noted in 67% of the swimmers. Conclusion high level swimming ineluctably weakens the shoulder joint complex.