Effectiveness of a Remotely Monitored Therapeutic Exercise Program on the Torque of Shoulder Rotator Muscles in Elite Swimmers

Abstract

Swimmer's shoulder is the most common injury among swimmers. It is a painful condition located in the anterior region of the shoulder, caused by the inappropriate application of kinetic energy from swimming techniques over time. This repetitive motion affects the soft tissues in the subacromial region of the shoulder. Therapeutic exercise has been identified as an effective intervention to prevent this injury. However, many questions remain regarding the characterization of this intervention and the magnitude of its effects. The main objective of this thesis was to evaluate the effectiveness of targeted exercise programs on musculoskeletal risk factors and on the prevalence of swimmer's shoulder. To achieve this aim, 30 competitive swimmers were recruited and randomly assigned to two intervention groups and a control group using stratified randomization. After reviewing the current scientific literature and conducting an electromyographic analysis, 2 programs consisting of 5 exercises each were chosen and implemented over 12 weeks. One experimental group performed a weights exercise program, while the other participated in an elastic band program. Both groups received individual supervision from a physiotherapist. Additionally, there was a control group that engaged in a placebo intervention. Before and after 12 weeks, the peak torque of the internal and external rotators of both shoulders was assessed using the isokinetic dynamometer Biodex System 3. This assessment was performed during both concentric and eccentric actions at angular velocities of 60º/s, 120º/s, and 180º/s. Following these evaluations, the conventional and functional ratios of the shoulders were calculated. Additionally, over 6 months, swimmer's shoulder episodes and respective characterization were registered among the participants. In general, the results indicated a decrease in the peak torque of the shoulder rotators, with a more pronounced decline observed in the control group. The experimental groups demonstrated improved rotator cuff balance at the end of the 12 weeks. There were no significant differences between the effects of the two preventive programs. Additionally, the experimental groups reported fewer episodes of swimmer's shoulder. In conclusion, integrating a specific program into the weekly routines of competitive swimmers appears to be an effective strategy for preventing swimmer's shoulder injury.