RECUPERACIÓN Y PREVENCIÓN DE LESIONES DE HOMBRO EN NATACIÓN

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Que los nadadores tienen unas exigencias enormes en sus hombros lo vimos en la entradas El hombro nadador, esto conlleva además que se produzcan una serie de adaptaciones y lesiones prevalentes que podéis leerlas en El hombro nadador dolorido .

Con el objetivo de evitar estas lesiones prevalentes o recuperarse de ellas, muchos nadadores realizan un trabajo de fuerza compensatorio, en el que los objetivos habituales son:

TRABAJO DEL MANGUITO ROTADOR: Especialmente el manguito rotador posterior (Infraespinoso y redondo menor), ya que estos deportistas suelen presentar una alteración en la ratio de fuerza entre rotadores externos e internos (Ver: Ganador del concurso internacional de ejercicico para el MRP). Además, el trabajo del manguito rotador posterior va a tener beneficios en los tejidos subacromiales, ya que el trabajo del manguito rotador aumenta el espacio subacromial (Ver: La casita subacromial), recuerda que si quieres un hombro feliz, deprime tu húmero.

ESTABILIZACIÓN ESCAPULAR⁹: Hay que prestar especial atención al trabajo del serrato anterior, ya que hemos visto en la entrada anterior que está prácticamente todo el tiempo activo cuando se realiza la técnica de crol, por lo que recomendamos ver ¡Un serrato para cortar esas alas!. Un ejemplo de ejercicio interesante puede ser el serratus punch, ya que ha demostrado tener una ratio serrato anterior/pectoral menor elevada, lo que suele ser muy interesante en nadadores porque hay una cierta tendencia a que el pectoral menor sea dominante.

CORE: El objetivo del core es la estabilización y trasmisión de fuerzas en la zona central del cuerpo, y esto lo vamos a conseguir si realizamos un trabajo específico en el que trabajemos más el control motor y la resistencia muscular que la propia fuerza. Nuestra propuesta en este objetivo es trabajarlo más dentro del agua, ya que lo importante es que consigamos beneficios lo más específicos posibles, hacer planchas en un nadador no le va a reportar grandes beneficios.

Corrección postural³³, especialmente el trabajo sobre el pectoral menor suele ser un trabajo prioritario. Laudner et al³⁵ comprobaron que el trabajo de facilitación neuromuscular propioceptiva durante 6 semanas produjo mejoras en la longitud del pectoral menor en nadadores escolares. Recomendamos ver la entrada La reinserción social del pectoral menor.

Ganancia de ROM en rotación externa glenohumeral: Ya vimos en la entrada anterior que tener una rotación externa por debajo de 93º o por encima de 100º son predictores de lesión, pero es más habitual que padezcan una reducción del ROM en rotación externa debido al desequilibrio muscular en favor de los rotadores internos que puede provocar un acortamiento adaptativo. En estos casos lo importante es que no nos limitemos exclusivamente a realizar estiramientos (eso lo sabe todo el mundo) y que hagamos uso de todas las herramientas que ha demostrado la ciencia son efectivos en mejorar el ROM.

Pero por mucho que duela ese hombro, lo primero que hay que pensar es que puede mejorar la eficiencia de sus movimientos y así disminuir el estrés local. En segundo lugar vamos a ver si la planificación del entrenamiento está siguiendo una progresión adecuada…. que no nos pasemos: Too much too soon. En tercer lugar vamos a ver que desequilibrios musculares, alteraciones de movimiento, ….. pueden estar favoreciendo la aparición del dolor. A equilibrar muscularmente, a planificar bien, a conseguir una buena técnica…. y al aguaaaaaa!!!

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