Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
©Journal of Sports Science and Medicine (2023) 22, 17 - 27   DOI:

Research article
Investigating The Association Between Supraspinatus Tendon Abnormality, Shoulder Pain and Isokinetic Strength in Elite Swimmers: A Cross-Sectional Study
Billy Chun Lung So1,2, , Stan Cheuk Ting Lau1, Wan Yu Kwok1, Daniel Hon Ting Tse1, Siu Shing Man1
Author Information
1 Gait and Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
2 Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong

Billy Chun Lung So
✉ Assistant Professor, ST506, Ng Wing Hong Building, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Chine
Publish Date
Received: 23-02-2022
Accepted: 05-12-2022
Published (online): 01-03-2023
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Shoulder pain is common among elite swimmers due to the tremendous stress over shoulders during swimming. Supraspinatus muscle is one of the major prime movers and stabilizers of shoulder and is highly susceptible to overloading and tendinopathy. An understanding of the relationship between supraspinatus tendon and pain; and between supraspinatus tendon and strength would assist health care practitioners for developing training regime. The objectives of this study are to evaluate 1) the association between structural abnormality of supraspinatus tendon and shoulder pain and 2) the association between structural abnormality of supraspinatus tendon and shoulder strength. We hypothesized that structural abnormality of supraspinatus tendons positively associated with shoulder pain and negatively associated with shoulder muscle strength among elite swimmers. 44 elite swimmers were recruited from the Hong Kong China Swimming Association. Supraspinatus tendon condition was evaluated using diagnostic ultrasound imaging and shoulder internal and external rotation strength was evaluated by the isokinetic dynamometer. Pearson’s R was used to study the correlation between shoulder pain and supraspinatus tendon condition and to evaluate the association between isokinetic strength of shoulders and supraspinatus tendon condition. 82 shoulders had supraspinatus tendinopathy or tendon tear (93.18%). However, there was no statistically significant association between structural abnormality of supraspinatus tendon and shoulder pain. The results showed that there was no association between supraspinatus tendon abnormality and shoulder pain and there was a significant correlation between left maximal supraspinatus tendon thickness (LMSTT) and left external rotation/ concentric (LER/Con) and left external rotation/ eccentric (LER/Ecc) shoulder strength (p < 0.05) while internal rotation/ external rotation (IR/ER) ratio can also be a significant predicator on LMSTT >6mm (R2 = 0.462, F = 7.016, df = 1, p = 0.038). Structural change of supraspinatus tendon was not associated with shoulder pain, but could be a predictor on MSTT >6mm in elite swimmers.

Key words: Elite swimmers, supraspinatus tendon abnormality, shoulder pain, isokinetic strength

           Key Points
  • Coaches and practitioners may take advantage of the effectiveness of a single limb body-weight conditioning activity, such as, i.e., alternating leg bounds as a part of pre-competition warm- ups to enhance subsequent performance without needing specific equipment.
  • The effectiveness of conditioning activity exercises appears to be force-vector specific, i.e., vertical drop jumps improve vertical jump performance, while horizontal drop jumps enhance sprint and change of direction performance.
  • The effects of single limb conditioning activity on the contralateral limb have not been thoroughly examined. However, the limited evidence shows that the post-activation performance enhancement effect is mainly local.
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