Research Review: Pain may alter recruitment patterns of shoulder musculature

By Stefanie DiCarrado DPT, PT, NASM CPT & CES

Edited by Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS

Original Citation: Scovazzo, M.L., Browne, A., Pink, M., Jobe, F.W., and Kerrigan, J.  (1991).  The painful shoulder during freestyle swimming: An electromyographic cinematographic analysis of twelve muscles. The American Journal of Sports Medicine. 19(6).  577-582 - ABSTRACT

Two segments of a freestyle swim stroke cycle

Why is this relevant?: Treating and preventing injury in an athletic population requires knowledge of optimal mechanics and muscle activity.  This paper offers a view on muscle activity in swimmers with and without shoulder.  It is recommended the reader also review the first article in this series that documents the results of freestyle swimmers without shoulder pain which will be reviewed on this site in the future (1).

Study Summary

Study DesignControlled Descriptive Study
Level of EvidenceLevel IIa: Evidence from a controlled study without randomization
Subject Demographics

  • Age: 31yrs (mean)
  • Gender: 5 females, 9 males
  • Characteristics: collegiate and masters level competitive freestyle swimmers with an average of 11 years experience, currently swimming 2500-4000 yards/day 3-4 days/week
  • Inclusion Criteria: "painful" shoulder defined as current shoulder pain with positive signs for shoulder instability, impingement, and/or apprehension.
  • Exclusion Criteria: Previous, but not current shoulder pain.
Outcome Measures

  • EMG activity levels during the 4 phases of a freestyle swimming stroke cycle in muscle group A & B (reported as a % of MMT value).

    • Group A: deltoids (anterior, middle & posterior), serratus anterior, upper trapezius, rhomboids
    • Group B: subscapularis, supraspinatus, infraspinatus,
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