Shoulder pain and disability predict clinical outcomes better than biomechanical and functional measures in young swimmers: a prospective cohort study

Abstract

Objective: This study investigated the association between shoulder pain, disability and functional measures in young competitive swimmers to identify risk factors for pain occurrence. Methods: In this prospective study, 32 swimmers (13–16 years) underwent clinical and functional assessments, including the Western Ontario Shoulder Instability Index (WOSI) and Upper Quarter Y Balance Test (UQ-YBT) performed on a force platform, with postural displacements quantified as resultant distance path length. Shoulder pain was self-reported after six months via telephone follow-up. Results: After six months, 9 (28%) swimmers reported shoulder pain within 6 months. Swimmers with shoulder pain showed higher WOSI scores (physical symptoms, sports/recreation, emotional domains, and total score), indicating greater dysfunction. UQ-YBT performance and balance measures showed no significant group differences. Logistic regression identified WOSI subscales as significant predictors of shoulder pain, with higher scores increasing the odds of pain occurrence. Age was also a predictor, with younger athletes at slightly higher risk. Conclusion: Clinical assessments like WOSI are better than functional tests in predicting shoulder pain risk in young swimmers, underscoring the importance of monitoring symptom-related disability for early prevention.