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03/11/2016 0 Comments

EL HOMBRO NADADOR

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Hola, soy un hombro nadador y voy a presentarme. Dicen que soy nadador de élite, nado 20-30 horas semanales, pudiendo dar 4000 brazadas por día1, y cerca del 90% de la capacidad propulsiva de un nadador proviene de las extremidades superiores43, donde yo colaboro mucho, y durante el recorrido de una brazada de crol me encuentro en posiciones de impingement durante el 24,8% del tiempo74,75. Viendo estos datos empiezo a comprender porqué tantos de los míos acaban lesionados o con molestias que se cronifican e impiden una vida deportiva competitiva; veo a muchos hombros nadadores quejarse, y es que el dolor musculoesquelético de hombro es el más común entre nadadores3,4,5,10,11,13,32,39,49,54,70. Entre jónenes nadadores de élite puede estar presente en el 91%54. Pero no queremos profundizar en las patologías asociadas, ya que eso podéis verlo en la entrada de blog  El hombro nadador dolorido

La natación, al igual que cualquier actividad que realizemos de forma repetida va a configurar un hombro con unas adaptaciones específicas a esta tarea, hablamos de adaptaiciones que aparecen tras muchos entrenamientos en el agua, y especialmente cuando se realiza de forma competitiva.

Adaptaciones a largo plazo:

«El resto de hombros que no nadan me ven raro, dicen que soy diferente, creo que la natación me ha cambiado…..»

Hipertrofia de la musculatura anterior del hombro4,33, debido a las excesivas revoluciones; y se ha relacionado con el dolor de hombro y la postura de hombros adelantados entre nadadoras de competición33,60. (Ver: Pectoral menor corto Imputado). La tensión sobre la apófisis coracoides en nadadores es frecuente y suele evidenciar un uso excesivo de esta musculatura y un desequilibrio habitual entre pectoral menor y serrato anterior.Recordemos que el pectoral menor se lleva la escápula a protracción realizando las tres rotaciones que disminuyen el espacio subacromial: rotación inferior, inclinación anterior y rotación interna; mientras que el serrato realiza la protracción llevando la escápula a las tres rotaciones que amplían el espacio subacomial: rotación superior, inclinación anterior y rotación externa.

Cifosis, cabeza adelantada, disminución de la lordosis cervical, escapulas en protracción y la cabeza del húmero anteriorizada y rotada internamente2,48.

Inestabilidad glenohumeral1,61,70. Algunos autores han observado un aumento en la laxitud capsular anterior e inferior21,29,73 que va a permitir más grados de movilidad en rotación externa, lo que aumenta las demandas al manguito rotador y tendón largo del bíceps para reducir la traslación superior y anterior.

La musculatura rotadora interna y aductora del hombro se hace más fuerte y más hipertrofiada que sus antagonistas19,69,71.

Aunque la natación se considera un deporte simétrico, se aprecian diferencias bilaterales al medir la fuerza rotacional en máquina isocinética8,22. (Ver: ITV Glenohumeral: Fuerza)

DRIG, aunque es estadísticamente significativo46, es muy pequeño, especialmente si lo comparamos con deportistas que realizan lanzamientos. Rienmann et al, achacan estas diferencias bilaterales a las actividades diarias y otras actividades recreacionales. Pérdida de aducción horizontal de 5,4º comparado con deportistas “Nonoverhead”25. (Ver: Historia anónima de un hombro lanzador: DRIG)

Es verdad que en determinados periodos de mi carrera deportiva como hombro nadador, tengo dolor, y debe tener algo que ver algunas de estas adaptaciones que se han explicado en esta entrada, pero os lo voy a detallar mucho más en la siguiente entrada: «El hombro nadador dolorido«.

El resto de hombros puede que me vean raro, pero me da igual…..no se dan cuenta que soy adicto al cloro, que a veces sueño que soy un delfín, y que cada vez que el agua y yo nos encontramos soy feliz.

BIBLIOGRAFÍA:

  1. Allegrucci M, Whitney SL, Irrgang JJ. Clinical implications of secondary impingement of the shoulder in freestyle swimmers. J Orthop Sports Phys Ther. 1994;20(6):307–318

  2. Ayub E, Glasheen-Wray M, Kraus S. Head posture: a study of the effects on the rest postion of the mandible. J Orthop Sports Phys Ther. 1984;5:179

  3. Bak K, Fauno P. Clinical findings in competitive swimmers with shoulder pain. Am J Sports Med. 1997;25(2):254–260

  4. Bak K, Magnusson SP. Shoulder strength and range of motion in symptomatic and pain-free elite swimmers. Am J Sports Med. 1997;25:454–460.

  5. Bak K. Nontraumatic glenohumeral instability and coracoacromial impingement in swimmers. Scand J Med Sci Sports. 1996;6:132–144.

  6. Bak K. The practical management of swimmer’s painful shoulder: etiology, diagnosis, and treatment. Clin J Sport Med. 2010 Sep;20(5):386-90.

  7. Batalha NM, Raimundo AM, Tomas-Carus P, Marques MA, Silva AJ. Does an in-season detraining period affect the shoulder rotator cuff strength and balance of young swimmers? J Strength Cond Res. 2014 Jul;28(7):2054-62.

  8. Beach ML, Whitney SL, Dickoff-Hofmann SA. Relationship of shoulder flexibility, strength, and endurance to shoulder pain in competitive swimmers. J Orthop Sports Phys Ther. 1992;16(6): 262–268.

  9. Ben Kibler W, Sciascia A. Rehabilitation of the Athlete’s Shoulder. Clin. Sports Med. 2008;27(4): 821-+.

  10. Borsa PA, Scibek JS, Jacobson JA, Meister K. Sonographic stress measurement of glenohumeral joint laxity in collegiate swimmers and age-matched controls. Am J Sports Med 2005;33:1077–84.

  11. Brushøj C, Bak K, Johannsen HV, Faunø P. Swimmers’ painful shoulder arthroscopic findings and return rate to sports [published online ahead of print June 28, 2006]. Scand J Med Sci Sports. 2007;17(4):373-377.

  12. Chase KI, Caine DJ, Goodwin BJ, Whitehead JR, Romanick MA. A prospective study of injury affecting competitive collegiate swimmers. Res Sports Med 2013;21:111–23.

  13. Ciullo JV. Swimmer’s shoulder. Clin Sports Med. 1986;5(1):115-137.

  14. Costill DL, Maglischo EW, Richardson AB: Swimming (Handbook of Sports Medicine and Science). Champaign, Ill, Human Kinetics, 1992.

  15. Couanis G, Breidahl W, Burnham S. The relationship between subacromial bursa thickness on ultrasound and shoulder pain in open water endurance swimmers over time. J Sci Med Sport. 2015 Jul;18(4):373-7.

  16. Counsilman JE, Counsilman BE: The New Science of Swimming, 2nd ed. Englewood Cliffs, NJ, Prentice Hall, 1994.

  17. Crotty NM, Smith J. Alterations in scapular position with fatigue: a study in swimmers. Clin J Sport Med. 2000;10(4):251–258.

  18. Falkel JE, Murray TF, Malone TR: Case principles: Swimmer’s shoulder. In Malone TR (ed): Shoulder Injuries. Baltimore: Williams and WIlkins, 1988, pp 109-126.

  19. Fowler PJ: Upper extremity swimming injuries. In Nicholas JA, Herschman EB (eds): The Upper Extremity in Sports Medicine. Louis: Mosby, 1990, pp 891-902.

  20. Fredericson M, Ho C, Waite B, Jennings F, Peterson J, Williams C, et al. Magnetic resonance imaging abnormalities in the shoulder and wrist joints of asymptomatic elite athletes. PM R 2009;1:107–16.

  21. Fu FH, Harner CD, Klein AH. Shoulder impingement syndrome: a critical review. Clin Orthop Relat Res. 1991;269:162-173

  22. Gozlan G, Bensoussan L, Coudreuse JM, et al. Isokinetic dynamometer measurement of shoulder rotational strength in healthy elite athletes (swimming, volley-ball, tennis): comparison between dominant and non-dominant shoulder. Ann Readapt Med Phys. 2006; 49(1):8–15.

  23. Harrington S, Meisel C, Tate A. A. Cross Sectional Study Examining Shoulder Pain and Disability in Division I Female Swimmers. J Sport Rehabil 2014;23:65–75.

  24. Heinlein SA, Cosgarea AJ. Biomechanical Considerations in the Competitive Swimmer’s Shoulder. Sports Health. 2010 Nov;2(6):519-25.

  25. Hibberd EE, Laudner K, Berkoff DJ, Kucera KL, Yu B, Myers JB. Comparison of Upper Extremity Physical Characteristics Between Adolescent Competitive Swimmers and Nonoverhead Athletes. J Athl Train. 2016 Jan;51(1):65-9.

  26. Hidalgo-Lozano A, Calderon-Soto C, Domingo-Camara A, Fernández-de-Las-Peñas C, Madeleine P, Arroyo-Morales M. Elite swimmers with unilateral shoulder pain demonstrate altered pattern of cervical muscle activation during a functional upper-limb task. J Orthop Sport Phys Ther 2012;42:552–8.

  27. Hidalgo-Lozano A, Fernández-de-las-Peñas C, Calderón-Soto C, Domingo-Camara A, Madeleine P, Arroyo-Morales M. Elite swimmers with and without unilateral shoulder pain: mechanical hyperalgesia and active/latent muscle trigger points in neck-shoulder muscles. Scand J Med Sci Sports. 2013 Feb;23(1):66-73.

  28. Hill L, Collins M, Posthumus M. Risk factors for shoulder pain and injury in swimmers: A critical systematic review.Phys Sportsmed. 2015 Nov;43(4):412-20.

  29. Jobe CM, Coen MJ, Screnar P. Evaluation of impingement syndromes in the overhead-throwing athlete. J Athl Train. 2000;35(3):293-299.

  30. Johnson JN, Gauvin J, Fredericson M. Swimming biomechanics and injury prevention: new stroke techniques and medical considerations. Phys Sportsmed. 2003;31:41-46.

  31. Johnson JN: Competitive swimming illness and injury: Common conditions limiting participation. Curr Sports Med Rep 2(5):267-271, 2003.

  32. Kennedy JC, Hawkins RJ. Swimmers shoulder. Physician Sports Med. 1974;2(4):34-38.

  33. Kluemper M, Uhl T, Hazelrigg H. Effect of stretching and strengthening shoulder muscles on forward shoulder posture in competitive swimmers. J. Sport Rehabil. 2006;15(1):58-70.

  34. Krüger PE, Dressler A, Botha M. Incidence of shoulder injuries and related risk factors among master swimmers in South Africa. African J Phys Heal Educ Recreat Danc 2012(Suppl):57–76.

  35. Laudner KG, Wenig M, Selkow NM, Williams J, Post E. Forward Shoulder Posture in Collegiate Swimmers: A Comparative Analysis of Muscle-Energy Techniques. J Athl Train. 2015 Nov;50(11):1133-9.

  36. Leão Almeida GP, De Souza VL, Barbosa G, Santos MB, Saccol MF, Cohen M. Swimmer’s shoulder in young athlete: rehabilitation with emphasis on manual therapy and stabilization of shoulder complex.

  37. Lintner D, Noonan TJ, Kibler WB. Injury Patterns and Biomechanics of the Athlete’s Shoulder. Sports Med. 2008;27(4):527-551.

  38. McKenna L, Straker L, Smith A. Can scapular and humeral head position predict shoulder pain in adolescent swimmers and non-swimmers? J Sports Sci. 2012 Dec;30(16):1767-76.

  39. McMaster WC. Shoulder injuries in competitive swimmers. Clin Sports Med 1999. 18(2):349–59.

  40. Murphy TC: Shoulder injuries in swimming. In Andrews JR, Wilk KE (eds): The Athlete’s Shoulder. New York, Churchill Livingstone, 1994, pp 411-424.

  41. Pink M, Jobe FW, Perry J, Browne A, Scovazzo ML, Kerrigan J. The painful shoulder during the butterfly stroke: an electromyographic and cinematographic analysis of twelve muscles. Clin Orthop Relat Res. 1993;288:60-72.

  42. Pink M, Perry J, Browne A, Scovazzo ML, Kerrigan J. The normal shoulder during freestyle swimming: an electromyographic and cinematographic analysis of twelve muscles. Am J Sports Med. 1991;19:569-576.

  43. Pink MM, Tibone JE. The painful shoulder in the swimming athlete. Orthop Clin North Am. 2000;31(2):247–261.

  44. Raine S, Twomey LT. Head and shoulder posture variations in 160 asymptomatic women and men. Arch Phys Med Rehabil. 1997;78:1215-1223.

  45. Richardson AB, Jobe FW, Collins HR. The shoulder in competitive swimming. Am J Sports Med. 1980;8:159-163.

  46. Riemann BL, Witt J, Davies GJ. Glenohumeral joint rotation range of motion in competitive swimmers. J Sports Sci. 2011 Aug;29(11):1191-9.

  47. Ristolainen L, Kettunen JA, Waller B, Heinonen A, Kujala UM. Training-related risk factors in the etiology of overuse injuries in endurance sports. J Sport Med Phys Fit 2014;54:78–87.

  48. Rocabado M. Biomechanical relationship of the cranial, cervical, and hyoid regions. J Craniomandiular Pract. 1983;11:3.

  49. Rupp S, Berninger K, Hopf T. Shoulder problems in high level swimmers–impingement, anterior instability, muscular imbalance? Int J Sport Med 1995;16:557–62.

  50. Ruwe PA, Pink M, Jobe FW, Perry J, Scovazzo ML. The normal and the painful shoulders during the breaststroke: electromyographic and cinematographic analysis of twelve muscles. Am J Sports Med. 1994;22(6):789-796.

  51. Sanders RJ, Rao NM. The forgotten pectoralis minor syndrome: 100 operations for pectoralis minor syndrome alone or accompanied by neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2010;24(6): 701–708.

  52. Santos MJ, Belangero WD, Almeida GL. The effect of joint instability on latency and recruitment order of the shoulder muscles. J Electromyogr Kinesiol 2007;17:167–75.

  53. Scovazzo ML, Browne A, Pink M, et al. The painful shoulder during freestyle swimming: an electromyographic cinematographic analysis of twelve muscles. Am J Sports Med. 1991;19:577–582.

  54. Sein ML, Walton J, Linklater J, Appleyard R, Kirkbride B, Kuah D, et al. Shoulder pain in elite swimmers: primarily due to swim-volume-induced supraspinatus tendinopathy. British Journal of Sports Medicine 2010;44(2):105e13.

  55. Spigelman T, Sciascia A, Uhl T. Return to swimming protocol for competitive swimmers: a post-operative case study and fundamentals. Int J Sports Phys Ther. 2014 Oct;9(5):712-25.

  56. Su KP, Johnson MP, Gracely EJ, Karduna AR. Scapular rotation in swimmers with and without impingement syndrome : practice effects. Med Sci Sports Exerc 2004 ; 36 : 1117-1123.

  57. Su KPE, Johnson P, Gracely EJ, Karduna AR. Scapular rotation in swimmers with and without impingement syndrome: practice effects. Med Sci Sports Exerc 2004: 36: 1117–1123.

  58. Swanik KA, Lephart SM, Swanik B, Lephart SP, Stone DA, Fu FH. The effects of shoulder plyometric training on proprioception and selected muscle performance characteristics. Shoulder Elbow Surg. 2002;11(6):579-586.

  59. Swanik KA, Swanik CB, Lephart SM, Huxel K. The effect of functional training on the incidence of shoulder pain and strength in intercollegiate swimmers. J. Sport Rehabil. 2002;11(2):140-154.

  60. Tate A, Turner GN, Knab SE, Jorgensen C, Strittmatter A, Michener LA. Risk factors associated with shoulder pain and disability across the lifespan of competitive swimmers. J Athl Train. 2012;47(2):149– 158.

  61. Thigpen CA, Padua DA, Michener LA, et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol. 2010;20(4):701–709.

  62. Thomas SJ, Swanik KA, Swanik C, Huxel KC. Glenohumeral rotation and scapular position adaptations after a single high school female sports season. J Athl Train. 2009 May-Jun;44(3):230-7.

  63. Tovin BJ. Prevention and Treatment of Swimmer’s Shoulder. N Am J Sports Phys Ther. 2006 Nov;1(4):166-75.

  64. Valadie AL III, Jobe CM, Pink MM, Ekman E, Jobe FW (2000) Anatomy of the provocative tests for impingement syndrome of shoulder. J Shoulder Elbow Surg 9:36–46.

  65. Van de Velde A, De Mey K, Maenhout A, Calders P, Cools AM. Scapular-muscle performance: two training programs in adolescent swimmers. J Athl Train. 2011 Mar-Apr;46(2):160-7; discussion 168-9.

  66. Virag B Hibberd EE Oyama S Padua DA Myers JB Prevalence of freestyle biomechanical errors in elite competitive swimmers. Sports health. 2014;6(3):218‐

  67. Walker H, Gabbe B, Wajswelner H, Blanch P, Bennell K. Physical Therapy in Sport Shoulder pain in swimmers: A 12-month prospective cohort study of incidence and risk factors. Phys Ther Sport 2012;13:243–9.

  68. Wanivenhaus F, Fox AJ, Chaudhury S, Rodeo SA. Epidemiology of injuries and prevention strategies in competitive swimmers. Sports Health. 2012 May;4(3):246-51.

  69. Weldon EJ, Richardson AB. Upper extremity overuse injuries in swimming. A discussion of swimmer’s shoulder. Clin Sport Med 2001. 20(3):423–38.

  70. Weon JH, Oh JS, Cynn HS, Kim YW, Kwon OY, Yi CH. Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. J Bodyw Mov Ther. 2010;14(4):367–374.

  71. West, D, Sole, G, and Sullivan, SJ. Shoulder external- and internalrotation isokinetic strength in master’s swimmers. J Sport Rehabil 14: 12–19, 2005.

  72. Wilk KE, Reinold MM, Andrews JR, eds. The Athlete’s Shoulder. Philadephia, PA: Churchill Livingstone; 2009.

  73. Woertler K, Waldt S. MR imaging in sports-related glenohumeral instability [published online ahead of print April 22, 2006]. Eur Radiol. 2006;16(12):2622-2636.

  74. Yanai T, Hay JG, Miller GF. Shoulder impingement in front-crawl swimming: I. A method to identify impingement. Med Sci Sports Exerc. 2000;32(1):21-29.

  75. Yanai T, Hay JG. Shoulder impingement in front-crawl swimming: II. Analysis of stroking technique. Med Sci Sports Exerc. 2000;32:30-40.

  76. Zemek MJ, Magee DJ. Comparison of glenohumeral joint laxity in elite and recreational swimmers. Clin J Sport Med 1996;6:40–7.

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