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Sonographic Stress Measurement of Glenohumeral Joint Laxity in Collegiate Swimmers and Age-Matched Controls

Paul A. Borsa, PhD, ATC^*,,, Jason S. Scibek, MA, ATC, Jon A. Jacobson, MD and Keith Meister, MD^||

From the Sports Medicine Research Laboratory, University of Florida, Gainesville, Florida, the Division of Kinesiology and Department of Radiology, University of Michigan, Ann Arbor, Michigan, and the ^|| TMI Sports Medicine and Orthopedics, Arlington, Texas

^* Address correspondence to Paul A. Borsa, PhD, ATC, University of Florida, 149 Florida Gymnasium, PO Box 118205, Gainesville, FL 32611-8205 (e-mail: pborsa{at}hhp.ufl.edu).

Background: Glenohumeral laxity that is greater than normal has been implicated as a causal factor in the development of shoulder pain and dysfunction in elite swimmers; however, quantitative evidence demonstrating greater-than-normal glenohumeral joint laxity in swimmers is lacking.

Objective: To quantify glenohumeral joint laxity in elite swimmers and nonswimming controls using stress sonography.

Study Design: Controlled laboratory study.

Methods: Force-displacement measures were performed bilaterally in 42 National Collegiate Athletic Association Division I swimmers and 44 age-matched controls. Of the 42 swimmers, 27 (64%) reported a history of unilateral or bilateral shoulder pain resulting from swimming. Ultrasound imaging was used to measure glenohumeral joint displacement under stressed and non-stressed conditions.

Results: An analysis of variance revealed no significant difference in glenohumeral joint displacement between swimmers (anterior, 2.82 ± 1.7 mm; posterior, 5.30 ± 2.4 mm) and age-matched controls (anterior, 2.74 ± 1.7 mm; posterior, 4.90 ± 2.7 mm). No significant difference in glenohumeral joint displacement was found between swimmers with a history of shoulder pain (anterior, 2.90 ± 1.6 mm; posterior, 5.42 ± 2.3 mm) versus swimmers without a history of shoulder pain (anterior, 2.74 ± 1.8 mm; posterior, 5.14 ± 2.6 mm). Shoulders displayed significantly more glenohumeral joint displacement in the posterior direction compared to the anterior direction (P < .001).

Conclusions: Our instrumented technique was unable to identify significantly greater glenohumeral joint displacement in elite swimmers compared to nonswimming controls, and elite swimmers with a history of shoulder pain were not found to have significantly more glenohumeral joint displacement compared to swimmers without a history of shoulder pain.

Clinical Relevance: Objective assessment of glenohumeral joint displacement in athletes participating in overhead-motion sports may be important for injury prevention and management.

Key Words: shoulder • force displacement • sonography • hyperlaxity • ligament

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