CLINICAL IMPLICATIONS OF SECONDARY IMPINGEMENT OF THE SHOULDER IN FREESTYLE SWIMMERS

Swimming has become a popular recreational activity as well as a highl y competitive sport in the United States. The repetitive nature of swi mming can predispose the shoulder to mechanical impingement and microt rauma, which may lead to laxity, rotator cuff fatigue, and subsequent secondary impingement. Improper stroke mechanics can place the swimmer 's shoulder at further risk. The purpose of this paper is to describe the pathology of secondary impingement in freestyle swimmers and to di scuss the clinical implications for rehabilitation of swimmers with th e pathology. A thorough subjective and objective evaluation is necessa ry to design a successful rehabilitation program. The rehabilitation p rogram for swimmers with secondary impingement includes modification o f training, flexibility, range of motion, strengthening, and mobilizat ion as indicated. Functional and proprioceptive training may also be u seful techniques in the rehabilitation of swimmer's shoulder. Improper stroke mechanics can also have clinical implications on swimmer's sho ulders with secondary impingement. The clinical implication of seconda ry impingement in freestyle swimmers suggests that the primary goal of rehabilitation is to promote equilibrium of the shoulder complex whil e accounting for the demands of the sport.