Prevalence of Shoulder Injury in Sports (Swimming, Tennis & Golf)

By Luqman Shaikh - Sports Scientist (UK), Sports Physiotherapist


The prevalence of shoulder pain in sports is quite high, especially in overhead sports that require repetitive overhead use of the shoulder joint. Sports such as swimming, tennis and overhead sports subject the shoulder to go under stress, fatigue, micro-trauma and laxity of static and dynamic stabilizers which alter functioning of the shoulder and predispose it to injury.


In the recent years, large number of sports have been studied in the literature including swimming, tennis and golf activities involving overhead activity. The cause of shoulder pain in athlete is usually due to the repetitive and high-energy forces going through the shoulder, leading to chronic stresses placed on the stabilizing structures of the shoulder.


When the stresses are applied to the shoulder it may lead to progressive damage to stabilizing structures. With continued stress, the static stabilizers (glenoid labrum, joint capsule, glenohumeral ligaments) of the shoulder becomes hyper-elastic, enabling anterior glenohumeral subluxation. Initially the dynamic stabilizers (the rotator cuff muscles, long head of the biceps tendon, scapulo-thoracic motion, and other shoulder girdle muscles such as the pectoralis major, latissimus dorsi, and serratus anterior) can compensate for this mild instability with increased muscle activity. However, with increased activity fatigue results, which in turn leads to overloading of these compensatory mechanisms.


Prevalence of Shoulder Injury in Swimmers

In the swimming population, the shoulder joint is particularly vulnerable with 90% of propulsive forces coming from the upper extremity. The shoulder is the most injured area in swimmers with studies showing different prevalence levels. A study revealed prevalence of shoulder pain in 75% of 1200 competitive swimmers from United States. Another study on high-level swimmers demonstrated a prevalence of interfering pain in 23% of athletes. Signs of impingement with orthopedic evaluation was revealed in 50% of the swimmers with pain.