National Collegiate Athletic Association Swimmers With Glenohumeral Multidirectional Laxity Have an Increased Glenohumeral Joint Range of Motion Profile

Abstract

Context: Adaptations in glenohumeral joint laxity and range of motion (ROM) are prevalent in competitive swimmers. Increased glenohumeral laxity in swimmers has been found to exist in multiple directions. However, it is unclear if swimmers with multidirectional laxity (MDL) possess altered glenohumeral ROM compared with swimmers without MDL. The purpose of this study was to compare the glenohumeral ROM characteristics of external rotation (ER), internal rotation (IR), total arc of motion (ER + IR), and total arc of motion ratio (ER/IR) between swimmers with MDL and without MDL. Our secondary objective was to investigate the effect of MDL on self-reported pain and function. Design: Observational study. Methods: Twenty-nine NCAA Division I swimmers (females: 15 and males: 14; age 19.5 [1.2] y; body mass index 23.9 [2.0] km/m2) participated in a preseason physical assessment including measures of glenohumeral ROM and joint laxity. These measures were used to determine the presence or absence of MDL for both shoulders of each participant. Glenohumeral ROM characteristics were compared between shoulders with MDL and shoulders without MDL with independent t tests. Self-reported pain and function scores were recorded biweekly across the season with a modified Kerlan-Jobe Orthopedic Clinic questionnaire. The seasonal average Kerlan-Jobe Orthopedic Clinic questionnaire scores were compared between swimmers with MDL and swimmers without MDL with analysis of variance, with factors of sex and MDL status. Results: Shoulders with MDL possessed increased glenohumeral IR (P < .001; effect size: 0.65) and total arc of motion (P < .004; effect size: 0.45) compared with shoulders without MDL. There were no differences in ER. There was no difference in self-reported pain and function between groups. Conclusions: Shoulders with MDL possess increased glenohumeral IR and total arc of motion compared with shoulders without MDL. The presence of MDL may not affect self-reported pain and function in competitive swimmers.