{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T21:23:44Z","timestamp":1793049824961,"version":"4.5.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T00:00:00Z","timestamp":1524182400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Curr Rev Musculoskelet Med"],"published-print":{"date-parts":[[2018,6]]},"DOI":"10.1007\/s12178-018-9485-0","type":"journal-article","created":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T06:36:39Z","timestamp":1524206199000},"page":"167-171","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["The Swimmer\u2019s Shoulder: Multi-directional Instability"],"prefix":"10.1007","volume":"11","author":[{"given":"Ivan","family":"De Martino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"Rodeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,4,20]]},"reference":[{"issue":"4","key":"9485_CR1","first-page":"34","volume":"2","author":"JC Kennedy","year":"1974","unstructured":"Kennedy JC, Hawkins RJ. Swimmers shoulder. Physician Sports Med. 1974;2(4):34\u20138.","journal-title":"Physician Sports Med"},{"issue":"6","key":"9485_CR2","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1177\/036354657800600602","volume":"6","author":"JC Kennedy","year":"1978","unstructured":"Kennedy JC, Hawkins R, Krissoff WB. Orthopaedic manifestations of swimming. Am J Sports Med. 1978;6(6):309\u201322.","journal-title":"Am J Sports Med"},{"issue":"5","key":"9485_CR3","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1097\/JSM.0b013e3181f205fa","volume":"20","author":"K Bak","year":"2010","unstructured":"Bak K. The practical management of swimmer\u2019s painful shoulder: etiology, diagnosis, and treatment. Clin J Sport Med. 2010;20(5):386\u201390.","journal-title":"Clin J Sport Med"},{"issue":"2","key":"9485_CR4","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1177\/036354659702500221","volume":"25","author":"K Bak","year":"1997","unstructured":"Bak K, Faun\u00f8 P. Clinical findings in competitive swimmers with shoulder pain. Am J Sports Med. 1997;25(2):254\u201360.","journal-title":"Am J Sports Med"},{"issue":"4","key":"9485_CR5","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1111\/j.1600-0838.2006.00571.x","volume":"17","author":"C Brushoj","year":"2007","unstructured":"Brushoj C, Bak K, Johannsen HV, Fauno P. Swimmers\u2019 painful shoulder arthroscopic findings and return rate to sports. Scand J Med Sci Sports. 2007;17(4):373\u20137.","journal-title":"Scand J Med Sci Sports"},{"issue":"1","key":"9485_CR6","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S0278-5919(20)31163-7","volume":"5","author":"JV Ciullo","year":"1986","unstructured":"Ciullo JV. Swimmer\u2019s shoulder. Clin Sports Med. 1986;5(1):115\u201337.","journal-title":"Clin Sports Med"},{"issue":"2","key":"9485_CR7","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1016\/S0278-5919(05)70150-2","volume":"18","author":"WC McMaster","year":"1999","unstructured":"McMaster WC. Shoulder injuries in competitive swimmers. Clin Sports Med. 1999;18(2):349\u201359.","journal-title":"Clin Sports Med"},{"issue":"8","key":"9485_CR8","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1055\/s-2007-973054","volume":"16","author":"S Rupp","year":"1995","unstructured":"Rupp S, Berninger K, Hopf T. Shoulder problems in high level swimmers: impingement, anterior instability, muscular imbalance? Int J Sports Med. 1995;16(8):557\u201362.","journal-title":"Int J Sports Med"},{"issue":"2","key":"9485_CR9","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1136\/bjsm.2008.047282","volume":"44","author":"ML Sein","year":"2010","unstructured":"Sein ML, Walton J, Linklater J, Appleyard R, Kirkbride B, Kuah D, et al. Shoulder pain in elite swimmers: primarily due to swim-volume-induced supraspinatus tendinopathy. Br J Sports Med. 2010;44(2):105\u201313.","journal-title":"Br J Sports Med"},{"issue":"8","key":"9485_CR10","doi-asserted-by":"publisher","first-page":"527","DOI":"10.5435\/JAAOS-D-15-00313","volume":"24","author":"E Matzkin","year":"2016","unstructured":"\u2022 Matzkin E, Suslavich K, Wes D. wimmer's Shoulder: Painful Shoulder in the Competitive Swimmer. J Am Acad Orthop Surg. 2016;24(8):527\u201336. https:\/\/doi.org\/10.5435\/JAAOS-D-15-00313 . The authors reviewed all the pathologies that can cause shoulder pain. They highlighted the importance of understanding the biomechanics of the stroke to better understand the etiology of shoulder pain in swimmers. The importance of the imaging and clinical examination were analyzed as well. Results with nonoperative and operative treatments were summarized for better comprehension.","journal-title":"J Am Acad Orthop Surg"},{"issue":"1","key":"9485_CR11","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1177\/036354659302100112","volume":"21","author":"WC McMaster","year":"1993","unstructured":"McMaster WC, Troup J. A survey of interfering shoulder pain in United States competitive swimmers. Am J Sports Med. 1993;21(1):67\u201370.","journal-title":"Am J Sports Med"},{"issue":"4","key":"9485_CR12","first-page":"166","volume":"1","author":"TBJ Prevention","year":"2006","unstructured":"Prevention TBJ. Treatment of Swimmer\u2019s Shoulder. N Am J Sports Phys Ther. 2006;1(4):166\u201375.","journal-title":"N Am J Sports Phys Ther"},{"issue":"3","key":"9485_CR13","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1016\/S0278-5919(05)70260-X","volume":"20","author":"EJ Weldon III","year":"2001","unstructured":"Weldon EJ III, Richardson AB. Upper extremity overuse injuries in swimming: a discussion of swimmer\u2019s shoulder. Clin Sports Med. 2001;20(3):423\u201338.","journal-title":"Clin Sports Med"},{"issue":"3","key":"9485_CR14","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1177\/1941738112442132","volume":"4","author":"F Wanivenhaus","year":"2012","unstructured":"Wanivenhaus F, Fox AJ, Chaudhury S, Rodeo SA. Epidemiology of injuries and prevention strategies in competitive swimmers. Sports Health. 2012;4(3):246\u201351.","journal-title":"Sports Health"},{"issue":"6","key":"9485_CR15","doi-asserted-by":"publisher","first-page":"262","DOI":"10.2519\/jospt.1992.16.6.262","volume":"16","author":"ML Beach","year":"1992","unstructured":"Beach ML, Whitney SL, Dickoff-Hoffman S. Relationship of shoulder flexibility, strength, and endurance to shoulder pain in competitive swimmers. J Orthop Sports Phys Ther. 1992;16(6):262\u20138.","journal-title":"J Orthop Sports Phys Ther"},{"issue":"4","key":"9485_CR16","first-page":"333","volume":"30","author":"D King","year":"1995","unstructured":"King D. Glenohumeral joint impingement in swimmers. J Athl Train. 1995;30(4):333\u20137.","journal-title":"J Athl Train"},{"issue":"6","key":"9485_CR17","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1177\/036354659101900603","volume":"19","author":"M Pink","year":"1991","unstructured":"Pink M, Perry J, Browne A, Scovazzo ML, Kerrigan J. The normal shoulder during freestyle swimming. An electromyographic and cinematographic analysis of twelve muscles. Am J Sports Med. 1991;19(6):569\u201376.","journal-title":"Am J Sports Med"},{"issue":"2","key":"9485_CR18","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/S0030-5898(05)70145-0","volume":"31","author":"MM Pink","year":"2000","unstructured":"Pink MM, Tibone JE. The painful shoulder in the swimming athlete. Orthop Clin North Am. 2000;31(2):247\u201361.","journal-title":"Orthop Clin North Am"},{"issue":"1","key":"9485_CR19","doi-asserted-by":"publisher","first-page":"31","DOI":"10.2519\/jospt.1999.29.1.31","volume":"29","author":"L Schmitt","year":"1999","unstructured":"Schmitt L, Snyder-Mackler L. Role of scapular stabilizers in etiology and treatment of impingement syndrome. J Orthop Sports Phys Ther. 1999;29(1):31\u20138.","journal-title":"J Orthop Sports Phys Ther"},{"issue":"7","key":"9485_CR20","doi-asserted-by":"publisher","first-page":"1117","DOI":"10.1249\/01.MSS.0000131955.55786.1A","volume":"36","author":"KP Su","year":"2004","unstructured":"Su KP, Johnson MP, Gracely EJ, Karduna AR. Scapular rotation in swimmers with and without impingement syndrome: practice effects. Med Sci Sports Exerc. 2004 Jul;36(7):1117\u201323.","journal-title":"Med Sci Sports Exerc"},{"key":"9485_CR21","first-page":"350","volume-title":"The shoulder and the overhead athlete","author":"SA Rodeo","year":"2004","unstructured":"Rodeo SA. Swimming. In: Krishnan SG, Hawkins RJ, Warren RF, editors. The shoulder and the overhead athlete. Philadelphia, PA: Lippincott: Williams & WIlkins; 2004. p. 350."},{"issue":"8","key":"9485_CR22","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1055\/s-2007-973054","volume":"16","author":"S Rupp","year":"1995","unstructured":"Rupp S, Berninger K, Hopf T. Shoulder problems in high level swimmers: impingement, anterior instability, muscular imbalance? Int J Sports Med. 1995;16(8):557\u201362.","journal-title":"Int J Sports Med"},{"issue":"1","key":"9485_CR23","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1097\/00042752-199601000-00009","volume":"6","author":"MJ Zemek","year":"1996","unstructured":"Zemek MJ, Magee DJ. Comparison of glenohumeral joint laxity in elite and recreational swimmers. Clin J Sport Med. 1996;6(1):40\u20137.","journal-title":"Clin J Sport Med"},{"issue":"1","key":"9485_CR24","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1177\/03635465980260013201","volume":"26","author":"WC McMaster","year":"1998","unstructured":"McMaster WC, Roberts A, Stoddard T. A correlation between shoulder laxity and interfering pain in competitive swimmers. Am J Sports Med. 1998;26(1):83\u20136.","journal-title":"Am J Sports Med"},{"issue":"6","key":"9485_CR25","doi-asserted-by":"publisher","first-page":"307","DOI":"10.2519\/jospt.1994.20.6.307","volume":"20","author":"M Allegrucci","year":"1994","unstructured":"Allegrucci M, Whitney SL, Irrgang JJ. Clinical implications of secondary impingement of the shoulder in freestyle swimmers. J Orthop Sports Phys Ther. 1994;20(6):307\u201318.","journal-title":"J Orthop Sports Phys Ther."},{"issue":"14","key":"9485_CR26","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1136\/bjsports-2013-092425","volume":"47","author":"WB Kibler","year":"2013","unstructured":"Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: The 2013 consensus statement from the \u2018Scapular Summit\u2019. Br J Sports Med. 2013;47(14):877\u201385.","journal-title":"Br J Sports Med"},{"issue":"9","key":"9485_CR27","first-page":"963","volume":"18","author":"FW Jobe","year":"1989","unstructured":"Jobe FW, Kvitne RS, Giangarra CE. Shoulder pain in the overhand or throwing athlete. The relationship of anterior instability and rotator cuff impingement. Orthop Rev. 1989 Sep;18(9):963\u201375.","journal-title":"Orthop Rev"},{"issue":"2","key":"9485_CR28","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1097\/JSM.0b013e3182041de0","volume":"21","author":"PH Madsen","year":"2011","unstructured":"Madsen PH, Bak K, Jensen S, Welter U. Training induces scapular dyskinesis in pain-free competitive swimmers: a reliability and observational study. Clin J Sport Med. 2011;21(2):109\u201313.","journal-title":"Clin J Sport Med"},{"issue":"6","key":"9485_CR29","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1177\/036354659101900604","volume":"19","author":"ML Scovazzo","year":"1991","unstructured":"Scovazzo ML, Browne A, Pink M, Jobe FW, Kerrigan J. The painful shoulder during freestyle swimming: an electromyographic cinematographic analysis of twelve muscles. Am J Sports Med. 1991;19(6):577\u201382.","journal-title":"Am J Sports Med"},{"issue":"14","key":"9485_CR30","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1136\/bjsports-2013-092425","volume":"47","author":"WB Kibler","year":"2013","unstructured":"Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: The 2013 consensus statement from the \u2018Scapular ummit\u2019. Br J Sports Med. 2013;47(14):877\u201385.","journal-title":"Br J Sports Med"},{"issue":"7","key":"9485_CR31","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1177\/0363546504272267","volume":"33","author":"PA Borsa","year":"2005","unstructured":"Borsa PA, Scibek JS, Jacobson JA, Meister K. Sonographic stress measurement of glenohumeral joint laxity in collegiate swimmers and age-matched controls. Am J Sports Med. 2005;33(7):1077\u201384.","journal-title":"Am J Sports Med"},{"issue":"1","key":"9485_CR32","first-page":"51","volume":"6","author":"P Page","year":"2011","unstructured":"Page P. Shoulder muscle imbalance and subacromial impingement syndrome in overhead athletes. Int J Sports Phys Ther. 2011;6(1):51\u20138.","journal-title":"Int J Sports Phys Ther"},{"issue":"6","key":"9485_CR33","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1016\/S0749-8063(03)00389-X","volume":"19","author":"SS Burkhart","year":"2003","unstructured":"Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: Spectrum of pathology. Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy. 2003;19(6):641\u201361.","journal-title":"Arthroscopy"},{"issue":"5","key":"9485_CR34","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1177\/0363546508329544","volume":"37","author":"RR Torres","year":"2009","unstructured":"Torres RR, Gomes JL. Measurement of glenohumeral internal rotation in asymptomatic tennis players and swimmers. Am J Sports Med. 2009;37(5):1017\u201323.","journal-title":"Am J Sports Med"},{"issue":"4","key":"9485_CR35","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.ptsp.2012.01.001","volume":"13","author":"H Walker","year":"2012","unstructured":"Walker H, Gabbe B, Wajswelner H, Blanch P, Bennell K. Shoulder pain in swimmers: A 12-month prospective cohort study of incidence and risk factors. Phys Ther Sport. 2012;13(4):243\u20139.","journal-title":"Phys Ther Sport"},{"issue":"11","key":"9485_CR36","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1080\/02640414.2011.587441","volume":"29","author":"BL Riemann","year":"2011","unstructured":"Riemann BL, Witt J, Davies GJ. Glenohumeral joint rotation range of motion in competitive swimmers. J Sports Sci. 2011;29(11):1191\u20139.","journal-title":"J Sports Sci"},{"key":"9485_CR37","doi-asserted-by":"crossref","unstructured":"Van de Velde A, De Mey K, Maenhout A, Calders P, Cools AM. Scapular-muscle performance: Two training programs in adolescent swimmers. J Athl Train 2011;46(2):160\u2013167, discussion 168-169.","DOI":"10.4085\/1062-6050-46.2.160"},{"issue":"2","key":"9485_CR38","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1177\/1941738108326705","volume":"1","author":"A Bedi","year":"2009","unstructured":"Bedi A, Rodeo SA. Os acromiale as a cause for shoulder pain in a competitive swimmer: a case report. Sports Health. 2009 Mar;1(2):121\u20134.","journal-title":"Sports Health"},{"issue":"2","key":"9485_CR39","first-page":"352","volume":"11","author":"A Frizziero","year":"2012","unstructured":"Frizziero A, Benedetti MG, Creta D, Moio A, Galletti S, Maffulli N. Painful os acromiale: conservative management in a young swimmer athlete. J Sports Sci Med. 2012;11(2):352\u20136.","journal-title":"J Sports Sci Med"},{"issue":"4","key":"9485_CR40","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1177\/036354659001800406","volume":"18","author":"JJ Warner","year":"1990","unstructured":"Warner JJ, Micheli LJ, Arslanian LE, Kennedy J, Kennedy R. Patterns of flexibility, laxity, and strength in normal shoulders and shoulders with instability and impingement. Am J Sports Med. 1990 Jul-Aug;18(4):366\u201375.","journal-title":"Am J Sports Med"},{"issue":"12","key":"9485_CR41","doi-asserted-by":"publisher","first-page":"3214","DOI":"10.1177\/0363546516657823","volume":"44","author":"SA Rodeo","year":"2016","unstructured":"\u2022 Rodeo SA, Nguyen JT, Cavanaugh JT, Patel Y, Adler RS. Clinical and ultrasonographic evaluations of the shoulders of elite swimmers. Am J Sports Med. 2016;44(12):3214\u201321. The authors evaluated the shoulder pain in 42 swimmers of the 2008 US Olympic team. Shoulder pain was reported by 29 of 42 (66%) athletes. Morphological changes consistent with tendinosis were common in the biceps (33\/46 shoulders; 72%) and supraspinatus\/infraspinatus (44\/46 shoulders; 96%). Subacromial impingement seen in 34 of 41 shoulders (83%). Tendinosis was more common in swimmers with a positive sulcus sign, suggesting a role for shoulder laxity.","journal-title":"Am J Sports Med"},{"issue":"4","key":"9485_CR42","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1080\/00913847.2015.1077097","volume":"43","author":"L Hill","year":"2015","unstructured":"\u2022 Hill L, Collins M, Posthumus M. Risk factors for shoulder pain and injury in swimmers: a critical systematic review. Phys Sportsmed. 2015;43(4):412\u201320. https:\/\/doi.org\/10.1080\/00913847.2015.1077097 . The authors performed a systematic review on the risk factors for shoulder pain in swimmers. A total of 29 papers were included in their final analysis. Eighteen risk factors for shoulder injuries in swimmers were found, and classified in four areas: shoulder joint anatomy and strength, activity history, demographics, and musculoskeletal anatomy. However, poor study methodology or limited available data caused constrained estimation of injury risk to the shoulder for almost all of the investigated risk factors.","journal-title":"Phys Sportsmed"}],"container-title":["Current Reviews in Musculoskeletal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s12178-018-9485-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12178-018-9485-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12178-018-9485-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T05:08:46Z","timestamp":1720242526000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s12178-018-9485-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,20]]},"references-count":42,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["9485"],"URL":"https:\/\/doi.org\/10.1007\/s12178-018-9485-0","relation":{},"ISSN":["1935-973X","1935-9748"],"issn-type":[{"value":"1935-973X","type":"print"},{"value":"1935-9748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,20]]},"assertion":[{"value":"20 April 2018","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with Ethical Standards"}},{"value":"Both authors declare that they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This article does not contain any studies with human or animal subjects performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights and Informed Consent"}}]}}