Identifying and managing shoulder pain in competitive swimmers: how to minimize training flaws and other risks.

Shoulder pain resulting from glenohumeral instability is common among competitive swimmers. The biomechanics inherent to swimming promote muscular imbalances that stress the capsuloligamentous structures and contribute to shoulder instability. Most swimmers respond favorably to conservative treatment of rest and rehabilitation, while a small percentage may ultimately require surgical intervention. Swimmers who respond well to rehabilitation have a better prognosis for a successful return to swimming than those who require surgery. Overall, education in proper stroke and training techniques can minimize the likelihood that a competitive swimmer will experience disabling shoulder pain.

Shoulder injections for osteoarthritis and other disorders.

Shoulder injection procedures are powerful diagnostic and therapeutic tools for the care of patients with osteoarthritis and other pathologic conditions of the shoulder-girdle region. Although questions regarding many of the details of the specific procedures still need to be answered, a modest body of literature is available. The musculoskeletal physiatrist is in a good position to contribute to this knowledge base through further clinical research.